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Background Advance Care Planning (ACP) is not routinely practiced in Indonesia, especially outside palliative care teams. In many cases, patients and families face uncertainty in making end-of-life decisions due to the absence of a standardized ACP framework. This case study, conducted at an oncology hospital in Jakarta, demonstrates the importance of ACP in guiding home-based palliative care decisions and respecting patients‘ end-of-life preferences.Methods In December 2023, a 43-year-old woman with stage IV cholangiocarcinoma (ECOG 3) was referred to the hospital’s palliative care team after disease progression following treatments, including chemotherapy and immunotherapy. Initially hesitant to discuss end-of-life plans, the patient engaged in ACP discussions late in her illness trajectory. Guided by the palliative team, she decided to discontinue immunotherapy and opted for home-based palliative care. A Do Not Resuscitate (DNR) order was agreed upon, and terminal care was managed at home with a fentanyl drip and oxygen therapy to alleviate symptoms.Results Although delayed, ACP discussions were transformative for both the patient and her family. The patient’s choice to receive home-based care allowed her to spend her final days surrounded by loved ones in a familiar environment. Symptom management was effective, ensuring comfort and dignity in her last moments. The family expressed deep gratitude for the support they received, which allowed them to honor the patient’s wishes and find emotional closure.Discussion This case underscores the vital role of ACP in enabling personalized end-of-life care in Indonesia. The lack of early ACP discussions and standardized protocols often leads to missed opportunities for patients to voice their preferences. Early ACP initiation, particularly in oncology settings, would provide patients and families with adequate time to prepare emotionally, logistically, and financially, while reducing distress during the final phase of life.Unique Contribution This study highlights the significant impact of ACP in home-based palliative care within a resource-limited and culturally nuanced setting. It advocates for the development of standardized ACP frameworks in Indonesian healthcare to ensure that patients‘ end-of-life wishes are consistently respected.Implications Integrating ACP as a routine practice in oncology and palliative care can enhance the quality of end-of-life care. Policy changes to establish standardized ACP protocols and promote earlier referrals to palliative care teams in urban hospitals, like those in Jakarta, are crucial to achieving this goal.