Table 4.

Attitudes Toward Discussing Older Patients’ Long-term Prognosis

Attitude	Example
Whether to discuss prognosis
Prognosis discussion is important	“I think there are probably cases where we may do a patient a disservice by waiting too long to bring [prognosis] up, because I think patients can make a more educated decision if they’ve been able to think through it and make a decision.”
Prognosis discussion is not important	“There’s also a part which is taking away their hope, so I would have to be pushed very hard, like in a situation where they were clearly going to make a wrong decision based on their feeling of prognosis, that would be the only situation where I’d be, like, we need to sit down and face facts, because until that if they feel like they’re going to live for 10 y, you know, let them, let them think…I don’t know that it’s such a bad idea for people to feel like they’re going to live.”
When to discuss prognosis
Earlier	“I think there’s a huge benefit to doing it earlier; the sicker you get the less clear things are, you know, having those conversations and revisiting them often…the sooner the better.”
Later	“Once they go into the hospital on a ventilator getting IVs it’s easier to have that [prognosis] discussion because you can see it, if a patient just walks into my room they can’t see it that they are that sick.”