Table 1:

Differences between end-of-life care for cancer, organ failure and frailty¹⁴

Characteristic	Cancer	Organ failure	Frailty
Trajectory	Progressive, accelerating deterioration	Unpredictable, with exacerbations and recoveries	Slow, progressive deterioration; sudden changes rare
Treatment	Curative/life-prolonging therapy often stopped at the time of transition to palliative care	Disease-modifying therapies provide symptom control; usually continued even for palliation	No effective disease-modifying therapies; treatment primarily supportive
Prognostication	Well-recognized syndromes or functional decline associated with prognosis < 6 mo	Prognostication challenging, especially beyond 3 mo; patients with “end-stage” disease can survive for years on life-sustaining therapies (e.g., dialysis)	Prognostication challenging; no reliable models for identifying final months
Needs/concerns	Pain/symptom control; fear of death; social and physical supports typically needed only in final weeks or months	Symptom control; decisions about life-sustaining therapies for organ failure (e.g., ventilation, dialysis, organ transplant); needs for social and physical supports often long standing and may exceed symptom burden	Functional decline, cognitive impairment greater concerns than fear of dying; symptoms variable
Typical patient demographics	Age 45–75 yr; often family caregiver	Age 70–85 yr; partner more likely to be deceased, or elderly and unable to provide support	Age ≥ 75 yr; partner more likely to be deceased, or elderly and unable to provide support
Typical patient location; composition of medical team	Community dwelling, with increasing visits to acute medical facility; care provided by single or multiple specialists (e.g., oncologist, with transition to palliative care specialist) associated with tertiary care facility	Community dwelling, with frequent visits to acute medical facility; care provided by multiple specialists or coordinated by general practitioner and a specialist; focus of care may be in tertiary care centre or primary care setting	Often residents of assisted-living or long-term care facilities; less frequent visits to acute medical facility; care generally provided by general practitioner based at assisted-living or long-term care facility; less affiliation with tertiary care centre
Professional/societal view of illness	Clearly viewed as life-limiting	Often viewed as chronic illness rather than life-limiting	Often not viewed as an illness