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 (also known as chronic disease or chronic illness) 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 ...
, or the steady decline in health due to
senescence
Senescence () or biological aging is the gradual deterioration of Function (biology), functional characteristics in living organisms. Whole organism senescence involves an increase in mortality rate, death rates or a decrease in fecundity with ...
(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
Anselm Leonard Strauss (December 18, 1916 – September 5, 1996) was an American sociologist professor at the University of California, San Francisco (UCSF) internationally known as a medical sociologist (especially for his pioneering attention ...
, 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
A myocardial infarction (MI), commonly known as a heart attack, occurs when Ischemia, blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. The most common symptom ...
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 that results from an anomalous response of the adaptive immune system, wherein it mistakenly targets and attacks healthy, functioning parts of the body as if they were foreign organisms. It is estimated tha ...
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 im ...
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 is the range of ages for people nearing and surpassing life expectancy. People who are of old age are also referred to as: old people, elderly, elders, senior citizens, seniors or older adults. Old age is not a definite biological sta ...
. 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 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
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life b ...
, 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 proce ...
*
Palliative care
Palliative care (from Latin root "to cloak") is an interdisciplinary medical care-giving approach aimed at optimizing quality of life and mitigating or reducing suffering among people with serious, complex, and often terminal illnesses. Man ...
References
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Death