Along with MileSAAver, there are still the, "unicorns," to be found. Last year I was able to snag award travel on QF (SFO-MEL in biz, SYD-DFW in F). So it is handy to have a stash of miles on hand for that (along with a subscription to Expert Flyer), plus as already mentioned any, "emergency," flights (ie., death, or other reason that you suddenly need to travel).

Occasionally I've used my miles for others... My sister and her husband got stuck in Mexico (they drove down, car had major issues, so they left it for family to take care of). Buying airfare would have been ridiculous, so I used miles for them. I've used miles for my mom and other family a few times too. You just have to be prepared to be their, "agent," should anything happen (which did once, and why I now hesitate).