EDITOR—The study of Salkeld et al in Australia of the choices of older patients in hypothetical illness scenarios is particularly pertinent to those of us dealing with patients in nursing homes.1 We are struck by the contrasting attitudes and expectations of the elderly patients with whom we are in daily contact. In our experience, most older Americans hold on to life very dearly and usually opt for even noxious treatments, such as chemotherapy, to gain a few months or years of …