This article presents a descriptive study about social workers' advance directive communication practices with hospitalized elderly patients at several hospitals located in upstate New York. The sample consisted of 29 social workers. The research surveyed advance directive communication practices by utilizing a self-administered questionnaire. Advance directive communication was operationalized as a cumulative process incorporating the following phases, which were measured as scales: initiation of the topic, disclosure of information, identification of a surrogate decision-maker, discussion of treatment options, elicitation of patient values, interaction with family members, and collaboration with other health care professionals. Results suggest that social workers frequently and comprehensively address the phases of the advance directive communication process in their practices with hospitalized elderly patients. Implications for the role of social workers as members of the interdisciplinary health care team are addressed.