Patients are considered to be in the terminal stages of dementia if the following criteria are met.
- Pt is at or beyond stage 7 of the FAST Scale
- Inability to ambulate independently.
This is critical. Studies indicate ambulating patients do not tend to die within six months, even if all other criteria are present
- Inability to dress without assistance
- Inability to bathe without assistance
- Urinary and fecal incontinence, intermittent or constant
- Inability to speak or communicate meaningfully
- Stereotypical phrases only or ability to speak limited to 6 or less intelligible words
- The presence of complications warranting medical treatment tends to decrease survival in advanced dementia (whether or not treatment was sought)
These conditions include:
- 10% weight loss during previous 6 months
- Aspiration pneumonia
- Pyelonephritis or other upper Urinary Tract Infection
- Septicemia
- Decubitus ulcers (Stage 3-4), multiple
- Fever, recurrent after antibiotics
- Inability or unwillingness to take food or fluids necessary to maintain life and refusal of tube feedings
- Serum albumin < 2.5 gm/dl
**If your patient does not meet the above criteria, they may still qualify for hospice
