Table 1.
Hospice Guidelines for Estimating Survival of Less Than 6 Months in a Patient with Dementia.*
Hospice guidelines for estimating survival of less than 6 months in a patient with dementia require that the patient meet the following two criteria regarding the Functional Assessment Staging (FAST) tool and medical conditions. |
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1. The patient must be at or beyond stage 7c on the FAST tool and have all the features of stages 6a through 7c: |
Stage 1: Has no objective or subjective difficulties |
Stage 2: Has subjective complaints of forgetting |
Stage 3: Has decreased job functioning that is evident to coworkers and difficulty traveling to new locations |
Stage 4: Has decreased ability to perform complex tasks (e.g., planning dinner for guests, handling finances) |
Stage 5: Requires assistance in choosing proper clothes for the day, season, or occasion |
Stage 6a: Cannot dress without assistance, occasionally or frequently |
Stage 6b: Cannot bathe without assistance, occasionally or frequently |
Stage 6c: Cannot perform mechanics of toileting without assistance, occasionally or frequently |
Stage 6d: Is incontinent of urine, occasionally or frequently |
Stage 6e: Is incontinent of bowel, occasionally or frequently |
Stage 7a: Has speech limited to fewer than six intelligible words during an average day |
Stage 7b: Has speech limited to one intelligible word during an average day |
Stage 7c: Is unable to ambulate independently |
Stage 7d: Cannot sit up independently |
Stage 7e: Cannot smile |
Stage 7f: Cannot hold up head independently |
2. The patient must have had at least one of the following medical conditions in the past year: |
Aspiration pneumonia |
Pyelonephritis or other upper urinary tract infection |
Septicemia |
Pressure ulcer, multiple, stage 3 or 4 |
Recurrent fever after treatment with antibiotics |
Eating problems, defined as food or fluid intake that is insufficient to sustain life (i.e., in tube-fed patients, weight loss of >10% during the previous 6 months or a serum albumin level of <2.5 g per deciliter) |
Data are from the National Hospice Organization.13