Background <p>Positive attitudes toward death are common among geriatric patients, yet their distinction from mental illness and suicidality remains insufficiently understood. This study sought to characterize the concept of a “friendly relationship to death” (FRD), including its frequency in a geriatric sample and identifying variables from the geriatric assessment associated with a FRD.</p> Methods <p>A cross-sectional study was conducted in a geriatric unit, surveying <i>N</i> = 99 patients aged 65 years and older. Attitudes toward death were assessed using The Multidimensional Orientation Toward Dying and Death Inventory<i> (</i>MODDI-F<i>)</i>, supplemented by one question addressing a FRD (“I have a friendly relationship to death.”), as well as eight additional questions on attitudes toward death, dying and religiosity/spirituality<i>.</i> Furthermore, depression, suicidality, disease burden, frailty, and loneliness were evaluated using validated questionnaires.</p> Results <p>A total of 70% of patients endorsed a FRD. A FRD was associated with greater acceptance of one’s own dying and death, lower fear and rejection of death, greater religiosity/spirituality, and a stronger sense of “satisfied hunger for life.” A FRD was not associated with depression, suicidality, overall disease burden, frailty or loneliness.</p> Conclusion <p>Among geriatric patients, a FRD appears to prevail, extending beyond a neutral acceptance of death’s inevitability and existing independently of suicidality, depression, frailty, or disease burden. Understanding a FRD may help contextualize older individuals’ acceptance of aging and could impact geriatric treatment outcomes.</p>