which disease and dying trajectory best represents the course

Three distinct illness trajectories have been described so far for people with progressive chronic illnesses (fig 1) 2 - 6: a trajectory with steady progression and usually a clear terminal phase, mostly cancer; a trajectory (for example, respiratory and heart failure) with gradual decline, punctuated by episodes of acute deterioration and some recovery, with more sudden, seemingly unexpected death; and a trajectory with prolonged gradual decline (typical of frail elderly people or people with dementia).

Full Answer

What is a disease and dying trajectory?

This Disease and dying trajectory represents the course for a person with an illness that causes a prolonged decline ending in death. This is the pattern for frail older adults often demonstrate, especially those with illnesses such as Alzheimer's. This type of care can be offered at any time in the disease trajectory.

What is the role of a nurse in disease/death trajectory?

Your role as a nurse is to advocate for patient access to this team and to work with the team to develop a plan of care consistent with patient's wishes. This type of disease/death trajectory involves unexpected and rapid death: MIs, accidents, violence.

Can we identify the turning point in the terminal disease trajectory?

Even allowing for the well-documented difficulties in accurate prognosis (e.g., Christakis, 1999), attentive clinicians can usually identify the turning point in the Terminal Disease Trajectory from management to accelerating decline.

Why is it important to understand and consider trajectories?

Understanding and considering trajectories may help professionals take on board, at an earlier stage than would otherwise be the case, that progressive deterioration and death are inevitable.

Which death trajectory is considered the most predictable?

In fact, the dying trajectory of cancer is one of the most predictable trajectories. Most patients with metastatic cancer remain quite functional until approximately five to six months before their deaths.

What are dying trajectories?

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.

What are the three types of illness trajectories?

MethodsDifferent trajectories for different diseases. ... Trajectory 1: short period of evident decline, typically cancer. ... Trajectory 2: long term limitations with intermittent serious episodes. ... Trajectory 3: prolonged dwindling.

What is the illness trajectory model?

11. Strauss et al5 described a Chronic Illness Trajectory Framework where the pattern of illness is characterised by a cycle of 'decline-reprieve-decline-reprieve-decline to death', which renders expectations uncertain and arrangements and plans unpredictable.

What is illness trajectory in palliative care?

An illness with a terminal trajectory is one that unequivocally should be accompanied by advance care planning and palliative care, ideally starting at diagnosis. Disease progression, while delayed almost to a standstill in some cases by effective treatments, will eventually result in the person's death.

What does trajectory mean in medical terms?

[trah-jek´tah-re] the movement of an object along a three-dimensional path, or of a projectile within an individual's body. 2. the course of a disease.

What is the difference between the terms disease course and illness trajectory?

Disease course refers to the symptoms and the characteristics of the disorder, while illness trajectory emphasizes the social and psychologic issues confronted by patients and families who experience health problems.

What is the trajectory of diabetes?

We define a diabetes trajectory as a sequence of comorbidities (i.e., HDL, HTN, and IFG) potentially leading up to diabetes.

What is dementia trajectory?

Despite the variations in the type and severity of symptoms and their respective patterns of development, most dementia's are typically a gradual onset, progressive in nature and are irreversible.

What is trajectory model?

Trajectory Model is a nursing model particularly applicable in situations of people with chronical diseases developed by Anselm L. Straus, medical sociologist and Juliet Corbin, a nurse theorist.

In which phase of the trajectory model of chronic illness are the symptoms under control and managed?

Phases in the Chronic Illness TrajectoryPhaseDefinitionStableSymptoms are under control and life activities continue within the limitations of the symptomsUnstableSymptoms start to get out of control and life activities are adjusted to cope with increasing health demands7 more rows•Jul 15, 2021

What are the three trajectories of chronic illness?

Three typical illness trajectories have been described for patients with progressive chronic illness: cancer, organ failure, and the frail elderly or dementia trajectory . Physical, social, psychological, and spiritual needs of patients and their carers are likely to vary according to the trajectory they are following.

What is the trajectory of cancer?

Trajectory 1: short period of evident decline, typically cancer. This entails a reasonably predictable decline in physical health over a period of weeks, months, or, in some cases, years. This course may be punctuated by the positive or negative effects of palliative oncological treatment.

What is the primary goal of palliative care?

Optimising quality of life before a timely, dignified, and peaceful death are the primary aims of palliative care. Understanding and considering trajectories may help professionals take on board, at an earlier stage than would otherwise be the case, that progressive deterioration and death are inevitable.

Can strokes mimic trajectory?

Some illnesses might follow none, any, or all of the trajectories: a severe stroke could, for example, result in sudden death or a fairly acute decline as in trajectory 1; a series of smaller strokes and recovery could mimic trajectory 2; while a gradual decline with progressive disability could parallel trajectory 3.