• Alexis Drutchas, Deborah S Lee, Sharon Levine, Jeffrey L Greenwald, and Juliet Jacobsen.
• Massachusetts General Hospital (A.D., D.S.L., S.L., J.L.G., J.J.), Harvard Medical School, Boston, Massachusetts, USA. Electronic address: adrutchas@mgh.harvard.edu.
• J Pain Symptom Manage. 2023 Sep 1; 66 (3): e313e317e313-e317.

ContextSerious illness conversations help clinicians align medical decisions with patients' goals, values, and priorities and are considered an essential component of shared decision-making. Yet geriatricians at our institution have expressed reluctance about the serious illness care program.ObjectivesWe sought to explore geriatricians' perspectives on serious illness conversations.MethodsWe conducted focus groups with interprofessional stakeholders in geriatrics.ResultsThree key themes emerged that help explain the reluctance of clinicians caring for older patients to have or document serious illness conversations: 1) aging in itself is not a serious illness; 2) geriatricians often focus on positive adaptation and social determinants of health and in this context, the label of "serious illness conversations" is perceived as limiting; and 3) because aging is not synonymous with illness, important goals-of-care conversations are not necessarily documented as serious illness conversations until an acute illness presents itself.ConclusionAs institutions work to create system-wide processes for documenting conversations about patients' goals and values, the unique communication preferences of older patients and geriatricians should be specifically considered.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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