Indeed, death is a personal journey that should be peaceful, pain free, and even happy. This is the main objective of doctors who created the Death Test, a 29-point checklist that helps them identify elderly patients who may die within 1 to 3 months.
The list, which is also referred to as CriSTAL (Criteria for Screening and Triaging to Appropriate Alternative care) includes the following points:
- A significant drop in blood pressure
- Oxygen therapy necessity
- Low urine output
- Seizure recurrence
- Altered conscious states
- Very low respiratory rate of no more than 30 but higher than 5
- Hypoglycaemia
- History of disorders such as heart failure, lung disease, many types of cancer, heart attack, stroke, dementia, kidney disease, recurrent emergencies including admission to the intensive care unit a few months before the abovementioned signs have been observed
- Exhaustion and weakness
- Unexplained weight loss
- Walking speed of no more than 5 meters in 7 seconds
- Blood in urine
- Irregular heartbeat
The list will provide a more accurate, honest, and thorough assessment of the current condition of the patient. This way, doctors can provide the right advice to family and friends including how to guarantee that the patient receives the best quality of life despite the impending death.
Researchers often discovered that the level of uncertainty and the lack of more knowledge on possible death compel families to subject elderly patients to procedures that may prolong their lives but cause more suffering and pain. It is a good way of helping family process the impending loss and face a reality that medicine can only do so much for someone. They can also spend the remaining days trying to address the patient's needs and desires.
The experts want to emphasize the checklist is merely to serve as an evaluation tool and should never replace whatever treatment or palliative protocol is being used on the elderly patient.