Dialysis units are increasingly grappling with considerations of the likely outcomes of dialysis therapy in older people. Patients 75 years or older are the fastest growing age group in dialysis internationally, with an overall increase of 57% in the United States over the last decade.1 More than one-fifth of incident dialysis patients in Australia and the United States1,2 are 75 years or older. Moreover, outcomes for older people commencing dialysis therapy are poor. Mortality rates for older patients (≥65 years) receiving dialysis in the United States are twice that of people with diabetes, cardiovascular disease, heart failure, or cancer.