Although there is extensive literature on Electroconvulsive Therapy (ECT) there is little documentation about how an individual makes the decision to receive a course of ECT. This study is an exploratory examination of the decision-making process of the mentally ill older adult who elects to receive ECT. This study provides a basis to plan clinical practice and build further research. A phenomenological design was chosen to explore the question: “What is the decision-making process of the older adult who has elected to receive ECT?” Study participants were seven non-demented older adults in a suburban geriatric medicine/psychiatry practice who elected to receive treatment with ECT. The lived experience of decision-making as perceived by these seven participants was a process that moved them toward wellness. The data showed four significant themes: Support, Trust, Past Experience, and Desperation. An overriding substative theme identified as an obstacle was the Stigma of Mental Illness.