I think it's important to consider the animal's quality of life, right now, in this moment. Is he in pain or nauseated? Also, is he frightened or confused? Dementia can be a real issue with senior animals, and I think people don't always realize just how distressing it is to the sufferer.
Additionally, I think it's important to be realistic about the prognosis for improvement or deterioration. A dog that has stopped eating for dental reasons will have improved quality of life after extraction of the painful teeth. A dog with diabetes may remain stable for months or even years on insulin. A dog in pain from cancer will probably see increasing numbers of bad days and decreasing numbers of good days.
Additionally, I think it's important to be realistic about the prognosis for improvement or deterioration. A dog that has stopped eating for dental reasons will have improved quality of life after extraction of the painful teeth. A dog with diabetes may remain stable for months or even years on insulin. A dog in pain from cancer will probably see increasing numbers of bad days and decreasing numbers of good days.