Background The research results from Taiwan have presented the contradictory phenomenon that the elderly residents in long-term care facilities have the high rates of willingness but low rates to sign their own do-not-resuscitate (DNR) consent.

Aim This study aimed to explore elderly nursing home residents’ attitudes when they need to sign their own DNR consent in Taiwan.

Methods The research adopted the purposive sampling method and collected data though participatory observation and in-depth interview. The data were analysed by a qualitative inductive content analysis, and the research field was located in the nursing home in eastern Taiwan.

Results Most of elderly nursing home residents in this study refused to make any decision about the end-of-life care by themselves. Content analysis of the interviews revealed four themes for declining to sign their own DNR consent: depending on children’ decision, trusting the doctor’s ability, accepting the arrangement from God, and regarding making decision by themselves as an unnecessary thing.

Discussion The Chinese cultural issues, such as filial piety and family-centre decision making, did affect the elderly autonomy and the elderly residents tended to make decision by someone except themselves in Taiwanese long-term facilities.

Conclusion With greater understanding of elderly nursing home residents’ attitudes, nurses can increase the family-centre autonomy by actively implementing the advance care planning for elderly residents, their families as well as the health providers to make decision together.