What is the impact of advance directives (AD) in our society? A general presentation of AD shows that end-of-life conditions create some fear in France. The unreasonable therapeutic obsession could be mitigated using AD. A psychologist describes an 18 months clinical case follow up: a 90-year-old person, treated for his chronic disease by dialysis, defines his AD, a stake of ambivalence and engagement. This work includes self-mourning and aging process mixed with the effects of chronic disease facing death to come. Do AD have a disturbing or highlighting purpose on the psychic progresses of the person towards his own end? The elaboration time and the connection work between patient, caregivers, family and medical staff seem to be a major benefit.