Thanks for the question.
Patients with chronic life-limiting conditions, such as ALS and COPD, are less likely to be identified. Even less likely to be identified are the frail elderly or patients with dementia.
It is really important to see patients for the whole of who they are and to see all of the complexities of their conditions added together to consider where they are on the trajectory of life and to identify early when we can intervene with palliative care to give them the best quality of life.