A few thoughts about the end of life for the survivors who make it to the end of their lives (the elderly, yes, they are the survivors of life).

When I do nursing home visits, very often, people have come to the end of their lives. They have come to the end of what medicine can do for them. Medicine can't fix ageing hearts, or kidneys, or brains. There is no cure for old age (yet, watch this space over next decades).

When it's very clear to us that the medicines don't work anymore, we have a very frank discussion about changing our goals from trying to cure things that can't be cured, to prioritising comfort and dignity above all else. Treating symptoms now matters more than cure.

(We never, ever, give up, or stop, or pull out. We do not use the word futile, nothing is futile because there is always something we can do. Whether it's medicine or surgery, morphine or ice cream, there's always something we can do. We are there to lives completion).

These decisions to switch from trying to cure, to reducing symptoms and prioritising comfort and dignity aren't made in a prescriptive way. They are done over multiple discussions with our patients and families, and their carers and us. No god complexes here.