Death trajectory
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Death trajectory is known as the pattern of dying when one is given a projected death date and there is limited to no medical recourse for the remaining existence of the individual's life.[1] It is essentially “the time between the onset of dying and the arrival of the death.” The death trajectory is dependent on the cause of death, whether it be a sudden death, chronic illness, or the long steady decline in health due to senescence.[2] Death trajectory is analyzed in two separate aspects: duration and shape. Duration refers to the length of time a patient has to live. It can be anywhere from instant death to several months. [1] Shape refers to how that duration is then graphed. In other words, shape is “the course of dying, its predictability, and whether death is expected or unexpected”.[1] The data is based on third-party observation, therefore, making death trajectories “perceived courses of dying, rather than actual courses themselves”.[3] Depending upon the diagnosis of the patient and their death trajectory, end-of-life plans can vary.
Dying trajectories were first studied in the 1960s by two researchers, Barney Glaser and Anselm Strauss, in order to understand how humans decline with different ailments and cancers.[4] However, death trajectory is still being studied to this day, despite sometimes being discredited due to "medical miracles."[5] These trajectories assist physicians in their approach to patient care, as well as individuals and their family's approach to end-of-life.[4]
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Premature death trajectory[edit]
Premature or sudden death occurs when the death of an individual is not perceived to be imminent. In a premature death trajectory, an otherwise healthy and high-functioning individual will suddenly die without any observable indications of oncoming demise. These types of deaths may include fatal accidents or inconspicuous health issues like myocardial infarctions or a severe stroke. Deaths that align with a premature death trajectory may happen over the course of a few days or in a matter of seconds. Individuals who follow this trajectory have not been given a death date so end-of-life plans are not as easily arranged.
Chronic malady trajectory[edit]
The chronic malady trajectory occurs with types of death such as autoimmune diseases, HIV, or other incurable illnesses. This process of death is characterized by "acute crises" and intermittent recoveries, all occurring during an overall decline in health.[2] The death trajectory projects emotional stress or turmoil,[1] until eventually the patient may become mentally and emotionally exhausted. In associated with medical professionals, the trajectory here is made more distinct to the family, and the afflicted individual, therefore making end-of-life plans more possible.[6]
Cancer[edit]
Cancer-related deaths are a notable example of the chronic malady trajectory because there is usually no hope for a curative approach, and death is imminent. Much like other chronic maladies, there is time to prepare for the individual's loss of life. However, this preparation time varies with different types of cancers as some are relatively quick growing, such as pancreatic cancer, while others act much slower, such as prostate cancer.[6]
Natural death trajectory[edit]
Natural death is typically a long, steady decline in regard to cancer or old age. In these cases, death trajectory is based more on how the mindset degenerates and the speed of organs failing. With these types of death, it is much easier to anticipate when an individual may die. This makes end-of-life planning more possible than with other death trajectories.[6][7]
When an individual has been given a death date and have a death trajectory, they will drop curative care, and proceed to comfort care.[1] 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 when a patient has accepted the reality that death is unavoidable. Here, the individual and their family will begin to take the necessary steps in order to make death as painless and comfortable as possible.
Often, patients who have been given an estimated death date and are following a consistent death trajectory are admitted into a hospice, and will die in the care of these programs and expertise. Bereavement counseling is often offered to the families, typically for up to 13 months.[5]
See also[edit]
References[edit]
- ^ a b c d e Corr & Corr (2012). Death & Dying, Life & Living, Seventh Edition. Cengage Learning. ISBN 978-1111840617.
- ^ a b "Preparing to say Good-Bye" (PDF). University of Hawaii. Retrieved 08 December 2016. Check date values in:
|access-date=(help) - ^ Dickenson, Johnson & Katz (2000). Death, Dying and Bereavement. SAGE Publications Ltd.
- ^ a b "Trajectory of Dying". http://depts.washington.edu/fammed/. University of Washington. Archived from the original on 6 March 2015. Retrieved 20 November 2014. External link in
|website=(help) - ^ a b Penrod, J.; Hupcey, J. E.; Baney, B. L.; Loeb, S. J. (27 September 2010). "End-of-Life Caregiving Trajectories". Clinical Nursing Research. 20 (1): 7–24. doi:10.1177/1054773810384852.
- ^ a b c Quan, Kathy. "Dying Trajectories". netplaces.com. Retrieved 20 November 2014.
- ^ Gerstorf, Denis; Ram, Nilam; Lindenberger, Ulman; Smith, Jacqui (2013). "Age and time-to-death trajectories of change in indicators of cognitive, sensory, physical, health, social, and self-related functions.". Developmental Psychology. 49 (10): 1805–1821. doi:10.1037/a0031340.
