The veterinarian should also recognize the limitations of the client in providing nursing care for their pet. In addition, having a frank discussion about the financial, physical, emotional, and time implications of different end-of-life care options may help the client come to a collaborative decision regarding end of life and their choice regarding euthanasia. Advanced age is not the only criterion for making medical decisions and does not preclude surgeries or other significant medical interventions depending on the goals of the client and the condition of the patient. Clinical scenarios that may affect QOL and influence decision making for the client may include anorexia, symptom progression, severe or unrelenting chronic pain, deterioration of a condition during active treatment, persistent cough even at rest, cognitive dysfunction progression, and mobility issues.