Death trajectory refers to the pattern of
dying when a patient is given a projected death date with limited or no medical recourse for the remaining existence of the individual's life.
The death trajectory is dependent on the cause of death, whether it is sudden death,
chronic illness
A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the course of the disease lasts for more than three mo ...
, or the steady decline in health due to
senescence
Senescence () or biological aging is the gradual deterioration of functional characteristics in living organisms. The word ''senescence'' can refer to either cellular senescence or to senescence of the whole organism. Organismal senescence inv ...
(aging).
Death trajectory is analyzed in two separate aspects: duration and shape. Duration refers to the period of time a patient has to live, which can be anywhere from imminent death to several months.
Shape refers to how that duration is then graphed. In other words, the shape is "the course of dying, its predictability, and whether death is expected or unexpected".
Dying trajectories were first studied in the 1960s by two researchers,
Barney Glaser and
Anselm Strauss, in an attempt to understand the end of human life from different ailments, including cancer.
Sudden death trajectory
Sudden or premature death occurs when the death of an individual is not perceived to be imminent. In a sudden death trajectory, an otherwise healthy and high-functioning individual will suddenly and
unexpectedly die without any observable indications of oncoming demise. People are at a high or normal level of functioning until the moment of death occurs. These types of deaths include fatal accidents and inconspicuous health issues like
myocardial infarction or severe stroke. Deaths that align with a sudden death trajectory may happen over the course of a few days or in a matter of seconds.
Chronic malady trajectory
The chronic malady trajectory occurs with types of death caused by
autoimmune disease
An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly a ...
s such as
HIV
The human immunodeficiency viruses (HIV) are two species of '' Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immu ...
or other incurable illnesses. This process of death is characterized by an overall decline in health accompanied by
acute crises and intermittent
recoveries.
The chronic malady trajectory projects emotional stress or turmoil;
the patient may eventually become
mentally and
emotionally exhausted.
Natural death trajectory
A natural death trajectory is typically a long, steady decline due to
old age
Old age refers to ages nearing or surpassing the life expectancy of human beings, and is thus the end of the human life cycle. Terms and euphemisms for people at this age include old people, the elderly (worldwide usage), OAPs (British usage ...
. In these cases, the death trajectory is based on how the mind and body degenerate, including the speed of organ failure. In these cases, it is much easier to anticipate a person's death.
Medical care
When someone has an estimated death date and a death trajectory, the patient's caregivers generally cease curative care and proceed to provide
palliative
Palliative care (derived from the Latin root , or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Wit ...
or comfort care.
Curative care refers to situations where the patient still feels it is possible to use current medical care to recover or become stable enough to carry on with life. Comfort care, or
hospice care, is reserved for patients who acknowledge they will not be able to recover.
See also
*
Aging-associated diseases
An aging-associated disease (commonly termed age-related disease, ARD) is a disease that is most often seen with increasing frequency with increasing senescence. They are essentially complications of senescence, distinguished from the aging pr ...
*
Palliative care
References
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Death