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. Author manuscript; available in PMC: 2016 Sep 24.
Published in final edited form as: N Engl J Med. 2015 Sep 24;373(13):1276–1277. doi: 10.1056/NEJMc1509349

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.
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