Background & Aim: In approaching the end of life, many decisions need to be made. And that is usually not a good time to make such decisions because of the illness or the change of mentation. Advance directives are forms in which the individuals would express their wish while they are still healthy or alert. However, it is not clear whether the advance directive that an individual filled out before, would express the same wish while the individual is acutely ill. The objective of this study is to answer whether there is a difference in advance directive of tube feeding in patients who are recovering from an acute illness as compared with the advance directive of tube feeding while they were healthy before. Methods: Patients at Covenant Village, a nursing in Northbrook, Chicago and in a Transition Care Unit (TCC) at ENH Hospital were interviewed. After an informed consent and a HIPPA form are signed, patients’ mental status was assessed with MMS. Only those patients with a normal mental status were included in the study. The general advance directive questions of intubation, cardiopulmonary resuscitation (CPR) and organ donation were asked. Then the question of feeding tube placement for nutrition was asked. A vignette from J.G. Ouslander of 11 pictures of tube feeding were shown and explained to the patients. Then the question of feeding tube placement for nutrition was again asked to the patients. Results: Total of 130 patients were interviewed: 107 from Covenant Village nursing home and 23 from TCC in an ENH hospital. The results are summarized in the table. Within the own group, the change from ‘yes’ to tube feeding before and after the presentation of the vignette did not reach statistical significance in either group. However, there was a big difference between the group recovering from acute illness and the nursing home group, in favoring tube feeding, either before or after the Vignette presentation. Conclusions: Patients recovering from acute illness tend to favor tube feeding possibly because they understand its importance. These findings also suggest that advance directive needs to be re-evaluated after a patient has undergone and recovered from a major illness since a major illness tends to change a patient’s perspective about the importance of feeding tube.