Advanced care planning and end-of-life care play an important role in older adults’ preparations for their aging life and death. This study examines associations among religion, familial cultures, and advanced care planning and end-of-life care decisions among female elderly Chinese Americans. Using semi-structured qualitative interviews, I estimated the effects of church life and family ties on these women’s attitudes toward death, family, and independent life. My findings illuminate several key pathways through which church communities and familial ties influence decisions regarding death among elderly Chinese Americans: (i) Shape their attitudes toward death and later life; (ii) Influence their living arrangements and family relationships; (iii) Guide autonomous decision-making in later life. These findings provide a new understanding of advanced care planning and end-of-life care services among elderly Chinese Americans under the impacts of Christian, American, and Chinese values related to family and aging life.