How is time to death calculated in terminally I’ll patients?
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A lot of the time, it’s not even calculated. It’s just referenced. Let’s say there’s a form of terminal cancer that a million people have died from in modern medical history. It would be pretty well known how quickly the disease progresses at that point.
Simple, how many days until the insurance runs out?
Usually just an educated guess by the doctors who from experience have seen so many they can give a good estimate based on the condition of the patient, the severity of their symptoms and the rate of decline.
Basically they compare it to lots of other patients with similar diseases.
Inaccurately.
It’s a guess, based on how similar cases have ended. Over time, as you get more sick, the estimate might get smaller or more accurate, but ?t’s just an educated guess.
To be honest docs tend to try to give a range, we rarely know that firmly for most things. Often you’ll say days vs weeks vs months vs years, rather than a set estimate. Some things are more predictable, but especially cancer often depends on where it spreads and what it does (eg lung cancer might kill someone earlier than expected if it causes lung collapse).
This is also why so many people have stories of “the doctors said I wouldn’t survive the night / walk again” etc. A good doctor isn’t going to say that your relative is going to live if there’s a 50/50 they die. They’re going to prepare you for the worst, because pretty much noone is going to be mad if someone unexpectedly survives, but if family feels unprepared, or that they had a lot of false hope…
Do you mean the prediction of how long someone likely has left? Or do you mean when someone who was terminally ill is found dead in bed, how do they work out the time to put on the certificate, rather than saying at some point between x and y time?
It’s really: on average 95% of people with your condition live 6-9 months from here.
That means some live more, some live less. And then there is 5% who are well outside that confidence interval
Kinda how you find the slope of a line, point a and point b, you find the rate of change. At two appointments they examine to find progress, and given the point at which death *usually* occurs, they can estimate when that will be based on current spread.
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It isn’t. You go by the current condition (respiration pattern, urinary output, blood pressure, color of extremities, etc.) and by experience you guess. That is the best you can do. I took care of a patient that seemed stable and was asked how long and my guess was days to a week. She died that hour. Another patient that was in a Cheyenne stokes respiratory pattern that was nearly agonal with almost no output went over a week until demise….the family even asked if I would routinely administer sedatives and narcotics to hasten death….of which I refused. I will gladly try to control pain and discomfort but by my oath to my profession I will not try to hasten death artificially.
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