Since its introduction by Malinowski in the 1920s, “phatic communion” has often been appealed to as a concept in sociolinguistics, semantics, stylistics, and communication, typically taken to designate a conventionalized and desemanticized discourse mode or “type.” But a negotiation perspective, following the conversation analysis tradition of research on greetings and troubles telling, fits the discursive realities better. Phaticity is a multidimensional potential for talk in many social settings, where speakers' relational goals supercede their commitment to factuality and instrumentality. We then analyze phatic processes in elderly people's responses to a scripted how are you? opening in interviews about their medical experiences. Discourse analyses of phatic communion can raise important issues for gerontological and medical research. (Phatic communion, small talk, greetings, elderly talk, medical talk, preference structure)