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Functional Assessment Staging

  • Functional Assessment Staging (FAST) for Dementia patients.
    • FAST score of 7A or greater may be necessary to qualify someone for hospice with diagnosis of dementia.
  • FAST focuses more on an individual's level of functioning and activities of daily living versus cognitive decline. Note: A person may be at a different stage cognitively (GDS stage) and functionally (FAST stage)
  • Functional Assessment Staging (FAST)

    Stage 1 -- Normal adult

    No functional decline

    Stage 2 -- Normal older adult

    Personal awareness of some functional decline.

    Stage 3 -- Early Alzheimer's disease

    Noticeable deficits in demanding job situations.

    Stage 4 -- Mild Alzheimer's

    Requires assistance in complicated tasks such as handling finances, planning parties, etc.

    Stage 5 -- Moderate Alzheimer's

    Requires assistance in choosing proper attire.

    Stage 6 -- Moderately severe Alzheimer's

    Requires assistance dressing, bathing, and toileting. Experiences urinary and fecal incontinence.

    Stage 7 -- Severe Alzheimer's

    Speech ability declines to about a half-dozen intelligible words. Progressive loss of abilities to walk, sit up, smile, and hold head up. (Reisberg, et al., 1988)

    7A - In a course of an average day or an intensive interview, no consistently meaningful verbal communication, only stereotypical phrases, or ability is speak is limited to 6 or fewer intelligible words.

    7B - In a course of an average day or an intensive interview, ability to speak is limited to the use of a single intelligible word which the patient may repeat over and over.

    7C - Ability to ambulate without personal assistance is lost.

    7D - Cannot sit up without assistance (patient will fall over if there are no lateral arm rests on the chair).

    7E - Loss of ability to smile.

    7F - Loss of ability to hold head up independently.

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