Our Project

Aims & objectives

The central aim of the TRAJECT project is to find out what is general and what is unique in older people's end-of-life experiences and the circumstances that shape them. This means rethinking the way we have been studying health trajectories and factors shaping them. This requires a new approach that recognizes both the common experiences shared by many people and the unique aspects of each individual’s journey. We should treat differences as valuable information, especially when looking at well-being and all the factors that contribute to health in the final stages of life.

The findings will offer insights into the medical, social, and emotional factors that impact well-being at the end of life. This will help healthcare providers better meet the needs of different groups of patients, improving care and ensuring comfort and dignity in their final stages of life.

Objective 1

What are the different temporal patterns of physical, social, psychological, and existential well-being that older people with serious chronic illness experience towards the end of life, and how are these patterns connected to their personal, medical, and social characteristics?

Objective 2

What are the common themes, the differences, and changes in the narratives of older people’s health and well-being as they approach the end of life?

Objective 3

What can be learned by combining these patterns of well-being and the narratives in a mixed-method approach to better clarify both shared experiences and unique differences of older people approaching the end of life?

Design

Convergent mixed-methods design including a quantitative longitudinal survey study, a serial narrative study, and a mortality follow-back survey.

Methods

WORKPACKAGE 1:
A quantitative longitudinal study will be conducted to gain a comprehensive understanding of how chronic illness impacts older adults over time. The study will involve 280 participants, each completing surveys seven times over the course of one year, with researcher visits every two months to assist in survey completion. The research aims to track and analyze the participants’ health trajectories, identifying potential patterns in their end-of-life experiences.

WORKPACKAGE 2:
Serial narrative interviews will be conducted with a smaller group of 30 participants from WP1, who will have seven open-ended interviews over the course of one year. WP1 focuses on identifying patterns in end-of-life trajectories, while WP2 explores the unique, subjective experiences of older adults with chronic illness. The qualitative study will provide deeper insights into the personal meanings these individuals attach to their experiences, emphasizing that these findings are specific to their trajectories and not generalizable.

WORKPACKAGE 3:
In WP3, upon the passing of a participant, a close family member or caregiver will be invited to take part in a mortality-follow back survey to gather insights into the final period of the participant’s life. This survey, conducted at least three months after the participant’s death to respect the family's grief, will be completed in person or via telephone. In addition to the survey, an open conversation will take place, allowing the family member to share the experiences of the participant especially with respect to healthcare utilisation during the last days of their life.

WORKPACKAGE 4:
In WP4, we will weave together the findings from all the work packages to compare the survey results with the open conversations. This analysis will highlight both the diverse and unifying aspects of participants' experiences, identifying what is different, what is common, and the reasons behind these patterns. By integrating data from WP1, WP2, and WP3, the study aims to develop a holistic understanding of the end-of-life trajectories of older people with chronic illness. The final goal is to capture the complexity of these experiences while also recognizing shared elements across participants.