Table 1.

 Elements of care important for patients coming to the end of life according to the 3 trajectories

Care	Trajectory
	Rapid decline over a few weeks or months before death	Chronic illness with intermittent exacerbations and sudden death	Very poor function, with long term slow decline
Model of care	Well coordinated care; integration with hospice or palliative care when needed	Disease management with education and rapid intervention when needed	Long term supportive care
Specific care needs	Maximise continuity; plan for rapid decline, changing needs, and death; at-home management of patient's symptoms, acute needs of the care giver, and the dying process	Education on self care; prevention, early recognition, and management of exacerbations to avoid hospital admission when possible; maintenance of function; assistance with decision making about potentially low yield interventions; plan for potential sudden death	Plan for long term care and future problems; avoid non-beneficial and harmful interventions; support and assistance for long term care givers; reliable institutional care when necessary