How to model life’s traȷectory from maȷor diagnosis to death

How do we model our lives from the time of a major diagnosis to death? Illness trajectories are one method, and they can help frame a conversation about what life will be like with a progressive illness. The three characteristic trajectories of decline are rapid (typically cancer), intermittent (declining organ function), and gradual (advanced frailty, neurological conditions, or major stroke). They can be used to inform person centred care and enable advance care planning. The trajectories may appear abstract, but the lives they describe are very real.Scott Murray and colleagues now propose a fourth trajectory to understand the lives of people with multimorbidity (doi:10.1136/bmj-2021-067896).1 Illness trajectories consider physical, social, psychological, and spiritual dimensions of wellbeing, which are best depicted in graphical form. The trajectory for multimorbidity shares some of the features of intermittent and gradual decline. What’s clear is that these tools are useful and complex and that any one…
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