Case study 1

An elderly man, Don Paige (not his real name) who suffers from chronic fibrositis. The recommended treatment is comprehensive and appears to incorporate every one of the four+ trajectories listed above. 

Could his illness have been prevented in the first place? Medical science can offer no direct cause of ‘myalgic’ trauma. Theories abound, but the research suggests, predictably, that unexplained changes in the handling of pain-processing within the central nervous system (CNS) is a significant factor.  

The trajectories are only of use if they slow down the ageing process and by implication the deterioration of body function in every context. Should the agenda still be adopted? 

Yes, especially if it coincides with measures taken by his doctor and hospitals to ameliorate his suffering. The drawback is that pain-killing drugs are not recommended in the agenda, except in the short term and in an emergency. Advanced care (4) seems to be the most helpful trajectory in Don’s case.”