May 7, 2019
This episode features Deidre Morgan (Palliative and Supportive
Services, College of Nursing and Health Sciences, Flinders
University, Adelaide, SA, Australia).
Functional decline can be anticipated for people with life-limiting
illnesses. Trajectories of functional decline differ in shapes and
patterns. Understanding patterns of functional decline has
implications for patient care and design of responsive health
services.
This prospective study identifies two contemporary trajectories of functional decline for patients receiving specialist palliative care in the last 120 days of life. Precipitous deterioration in functional decline for cancers, solid organ failure and cardiovascular disease occurs as cohorts of patients approach Australia-modified Karnofsky Performance Status (AKPS) of 40. The pattern of functional decline for the neurological and dementias cohorts is flatter, showing a prolonged period of low function.
Study findings highlight that different types of care responses
and resource allocation may be needed at different time points in
different trajectories. This may require rapid mobilisation of
carer support and modification of care plans preceding a
precipitous functional decline (Trajectory 1). Extended periods of
support to maintain patient function and support carers are
required for those with a prolonged slow rate of functional decline
(Trajectory 2).
Full paper available from: https://journals.sagepub.com/doi/full/10.1177/0269216319839024
If you would like to record a podcast about your published (or
accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:
anwosu@liverpool.ac.uk