Disability and medical dependence increase with age and as the percentage o
f the population over 80 yr old increases, demands on our healthcare budget
will likewise grow. Clinical decision making should always balance the phy
siological state of the patient against the likely prognosis of the patholo
gical state. Age may influence this decision-making process in an indirect
way, as a perceived measure of physiological status, but whether age alone
may be used as criteria for the type or degree of clinical intervention is
a contentious point. In light of these issues, we present a woman of 113 yr
, admitted to hospital with a fractured shaft of femur. The patient underwe
nt surgery and was electively admitted to the intensive care unit for posto
perative treatment. She survived surgery and several complications and was
subsequently returned to the community where she celebrated her 114th birth
day.