I am leaving a room where I had a discussion with a son and daughter who strongly desired that their 94-year-old mother with severe dementia, chronic obstructive pulmonary disease, a history of heart disease with triple-bypass surgery, and 2 repaired hip fractures continue her statin and all her other medications. I've had many discussions like this, trying to clarify goals of care as well as what medicines we should use. More than 50 years ago, Albert Einstein said that we live in an age characterized by perfection of means and confusion of goals. We’ve come a long way in 50 years, yet many of these same issues remain.