3 Common Disease Trajectories

Understanding disease trajectories helps the palliative care team, patients and their families plan for their care. In this video, we cover 3 common disease trajectories and how they affect care approaches.


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Recap 📝

Patients with palliative care needs commonly have one of the following categories of illnesses:
○ Cancer
○ Organ failures such as heart failure or kidney failure
○ Frailty-related illnesses such as dementia or Parkinson’s disease.

3 common disease trajectories:

1. Rapid trajectory that usually happens in cancer. It is characterized by a fast physical decline towards the last few months of life. As the patient becomes weaker, it also means that the illness is developing faster.

2. Intermittent trajectory that usually happens in organ failure. It is characterized by episodes of sharp physical declines due to acute medical changes. There can be recovery of function after each episode but it may not return to the original function. The prognosis of the disease is difficult as any one crisis can result in death.

3. Gradual trajectory that usually happens in frailty. It is characterized by a very slow functional decline over time. There is no clear sign as to when the patient is at the end-of-life stage. The slow decline also means that caregivers and families are at risk of burnout due to prolonged caregiving.

Animation transcript: https://bit.ly/3j87Cy0

References
1. Murray SA, Kendall M, Boyd K, Sheikh A. Illness trajectories, and palliative care. BMJ. 2005 28;330:1007-11.
2. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA. 2003;289:2387-92.

Content expert: Dr. Laurence Tan
Video producer: Perry Lee
Script composer: Lim Yujun
Voiceover: Joanne Chia
This video is done in collaboration with GERI Institute - https://www.geri.com.sg/

All rights are reserved to GeriCare and there should not be any reproduction, publication, or adaptation of any part of the video content without prior approval from GeriCare.
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