To prepare for end of life, patients must understand and cope with prognostic information. Yet misunderstandings, in which a patient does not seem… to understand what was said, are common. In this talk, I will discuss an approach for patients who do not seem to understand the prognosis. First, I will review how patients’ healthy coping patterns can contribute to misunderstandings. Then, I will discuss how clinicians can approach patients with curiosity by generating a differential diagnosis for misunderstandings. Finally, I will share a systems solution that enables clinicians to coordinate conversations over time and across settings to support patients’ development of prognostic awareness.