Chapter 3: Outlining what to expect


Families may be frustrated that the health care team hasn’t given them an accurate prognosis. Although most health care providers understand how difficult it is to accurately predict life expectancy, most families don’t know this. 

Each person's trajectory will follow its own course. While there are many common features, there can be significant and sometimes startling variations. 

Factors affecting prognosis

  • Aggressiveness of the disease.
  • Infections.
  • The patient’s unique physiology and how it responds to the illness.

  • The patient’s personality and understanding of their impending death.

Momentum of change

A straightforward way to help families understand both disease progression and life expectancy is to review the current momentum of change. If changes are happening over weeks, the person likely has weeks to live. If changes are happening over days, they likely have days to live. Although this isn’t an exact science, it’s fairly reliable and may give families the information they need to prepare emotionally and logistically for death.