Human Growth and Development / Unit 17 HGD 2407 worked example, 60 to 90 seconds
Dying Trajectories
The idea
Dying trajectories are pathways to death that differ in the nature and rate of decline; Glaser and Strauss proposed three, and Lunney and colleagues described four. Sudden death is an abrupt loss of function, as in a heart attack or accident. Terminal illness keeps a high level of functioning, then brings a steep decline, as often in cancer. Organ failure brings gradual decline with cycles of worsening and improvement, as in heart or kidney failure. Frailty is low functioning with steady decline and no recoveries, as in dementia.
In practice
Four patients on a hospice ward: one after a stroke, one with cancer, one with heart failure repeatedly hospitalized, one with advanced dementia.
Where people slip
Each trajectory brings different adjustment: terminal illness goes with more depression and anxiety for the dying person, frailty with heavier emotional and financial burdens for caregivers. Exam items describe the course of decline and ask for the trajectory.
Your place on the trail
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