Two out of three seniors over 60 report having two or more chronic conditions and just under half have three or more, so we’re talking about a lot of folks facing these kinds of considerations. Their answers depend a lot on what their goals are. What factors should be weighed? Is watchful waiting a good option? What about adherence to regimens if the patient has dementia? What are the most important aspects of their lives? These questions need to be raised by patients, by families and thoughtful practitioners. And in raising them, we need to craft responses that reflect values, preferences and goals that clearly matter to them; not what’s clinically expedient or meets some prescribed pathway.