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OBJECTIVES: To examine the ways in which older persons with multiple conditions think about potentially competing outcomes in order to gain insight into how processes to elicit values regarding these outcomes can be grounded in the patient's perspective.

DESIGN: Qualitative study consisting of purposefully sampled focus groups.

SETTING: Community.

PARTICIPANTS: Persons aged 65 and older taking five or more medications.

MEASUREMENTS: Participants were asked their perceptions about whether their illnesses or treatment interacted with each other, goals of their treatment, and decisions to change or stop treatment.

RESULTS: Although participants were largely unaware that treatment of one condition could worsen another, many had experience with adverse medication effects as a competing outcome. Participants initially discussed their conditions in terms of disease‐specific outcomes, such as …