Death trajectory refers to the pattern of
dying
Dying is the final stage of life which will eventually lead to death. Diagnosing dying is a complex process of clinical decision-making, and most practice checklists facilitating this diagnosis are based on cancer diagnoses.
Signs 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, or the steady decline in health due to
senescence (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
Barney Galland Glaser (1930-2022) was an American sociologist and one of the founders of the grounded theory methodology.
Glaser was born on February 27, 1930, in San Francisco, California, and lived in nearby Mill Valley. He received his Bache ...
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 t ...
, 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 blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...
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 diseases 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 immune ...
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. 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 by ...
, is reserved for patients who acknowledge they will not be able to recover.
See also
*
Aging-associated diseases
*
Palliative care
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 ...
References
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Death