Table 1. Lines-of-defense model for motivational regulation with a progressive disease.

Disease State	Health Goal	Functioning Goal	Control Strategy
1. Disease free	Enhance resilience to disease by preventive health behavior Maintain disease free status		Engagement
2. Subclinical disease	Revert to disease free state Maintain status quo Minimize progression		Engagement => disengagement => reengagement
3. Chronic disease	Revert to subclinical or disease free state Avoid disease progression	regain or maintain lost physical abilities maintain independence using assistive devices and environmental modifications seek and accept help from others focus on important I/ADL minimize physical suffering	At each sublevel: cycles of engagement => disengagement => reengagement
4. Terminal illness		minimize psychological suffering and promote existential acceptance minimize physical suffering	Disengagement Engagement