What Does Stage 7 Look Like
Stage 7 is the final stage of cognitive disease. The individuals ability to speak will dwindle and ultimately go away. He or she will lose their remaining abilities, becoming incontinent and unable to walk. Communication with others will soon become impossible. Finally, the body will start to shut down and the individual will pass away.
Stage : Normal Older Adult
At this stage, Alzheimers patients start to show very mild memory loss. They tend to forget the location of everyday objects like keys, eyeglasses, etcetera. Some may also suffer from memory lapses like forgetting familiar words or names. These impairments are usually noticed by friends and family but may not show during clinical evaluations.
How To Know It May Be Time For Hospice
Watching someone you love suffer from Alzheimers or another memory debilitating illness is incredibly difficult, and it can be even more challenging to decide when its time to consider hospice care. Our latest video discusses the following five signs that indicate it may be time for hospice for an Alzheimers patient.
1.Physician determines they are at or beyond stage 7 of the Functional Assessment Staging Scale
The Functional Assessment Staging Scale is a tool used to determine if changes in a patients condition are related to Alzheimers disease or another condition. If due to Alzheimers, the changes will occur in sequential order. Alzheimers disease-related changes do not skip FAST stages.
2.Unable to ambulate independently
This means a person is no longer able to get around on their own. For example, they require assistance getting from room to room.
3.Requires assistance to dress or bathe
Without assistance, you may notice they put their shoes on the wrong feet or their day-time street clothes on over their pajamas. They are also unable to bathe without assistance.
4.Becomes incontinent
You May Like: Did Margaret Thatcher Have Dementia
How Can The Fast Scale Help Determine What Type Of Dementia My Loved One Has
One interesting thing about the FAST Scale is that, if the individual has Alzheimers disease, any changes they experience will be in sequence that is, FAST stages wont be skipped over. If the individual loses certain abilities listed at a later stage but still retain abilities from an earlier stage . This is incredibly helpful, because it means their situation can potentially be treatable.
Bristol Activities Of Daily Living Scale
The Bristol Activities of Daily Living Scale was designed specifically for use in patients with dementia and covers 20 daily living activities. It takes a carer 15 min to administer. It is sensitive to change in dementia and short enough to use in clinical practice . It is regularly used as an outcome measure in clinical trials, where it is world leading as a dementia-specific measure. This outcome is among those recommended by a consensus recommendation of outcome scales for nondrug interventional studies in dementia .
Read Also: What Color Ribbon Is Alzheimer’s
What Does Pps 40 Mean
According to the PPS scoring definitions, a score of 30% indicated the patient was totally bedbound, unable to do any activity, had extensive disease and required total care whereas a score of 40% indicated the patient was mainly in bed, unable to do most activity with extensive disease and required assistance for
Inclusion And Exclusion Criteria
Specific inclusion and exclusion criteria were established to identify studies dealing exclusively with prognosticators of 6-month mortality in patients with advanced dementia . Our exposure was advanced dementia of an organic origin, and our outcome was death within 6 months according to the natural progression of dementia .
Recommended Reading: What Is The Difference Between Dementia And Senility
Developing The Fast Scale For Dementia
Before and after Doctors Alzheimer and Fisher discovered plaques and tangles, doctors described dementia in various ways and developed terms like “benign senescent forgetfulness” in 1962. Some even quantified ways to measure the stages of dementia.
In the late 1970s, a professor of psychiatry at New York University began making great strides in studying dementia and Alzheimer’s. Dr. Barry Reisberg introduced a reliable way for families and medical doctors to measure symptoms of dementia to understand patient needs and provide the best treatment possible, calling it the Functional Assessment Staging Tool or the FAST Scale.
Understanding The Fast Scale: How Dementia Progresses
The Functional Assessment Staging Tool, otherwise known as the FAST Scale, is used to evaluate the progression of dementia in patients with Alzheimers. It wasdesigned by a leading expert in Alzheimers disease, Dr. Barry Reisberg.
In his research, Dr. Reisberg found that the symptoms of Alzheimers follow a certain pattern. This pattern is similar to normal human development but in reverse. He called this process retrogenesis.
His studies gave way to a documented description of dementia symptoms. All of which are contained in the FAST Scale. This makes it the most well-validated measure of dementia progression in scientific literature.
This is also why the FAST Scale is the most widely-used tool by nursing home professionals. It divides dementia into seven stages. This helps them determine the type of care and intervention an Alzheimers patient needs at every stage.
Read Also: What Color Ribbon Is Alzheimer’s
How Does The Fast Scale Determine Eligibility For Hospice Services
Dementia is a progressive and terminal disease, but it is nearly impossible to determine how long a person will live. Hospice services can be incredibly helpful for those with late-stage dementia, but many caregivers arent aware that their loved one can qualify for these services. If a person with dementia is at Stage 7 of the FAST Scale, they can generally qualify for hospice services. The signs that doctors and professionals look for are incontinence, inability to handle the daily tasks of living and being unable to speak meaningfully or express their thoughts.
A diagnosis of dementia is life-changing and can be scary for everyone involved. Using the FAST Scale to determine the severity of someones dementia can help people feel informed and be proactive about the changes along the memory loss journey.
Avalon Memory Care is well-versed in the FAST Scale and helping families understand whats ahead. If you have any questions about the FAST Scale, or if youd like to find resources to determine what level you or a loved one may be experiencing, please contact us at 713-1383.
How Do You Know If Your Ready For Hospice
8 Signs It May be Time For Hospice Care
Also Check: What Color Ribbon For Dementia
Is Fast Scale Only For Alzheimer’s
Alzheimer’s Disease always progresses through the FAST scale in order, although there are other dementia conditions that do not, and where patients might skip stages. We’re often asked how long late stage dementia or Alzheimer’s disease last, but the speed at which a person moves through the scale can vary.
Stage : Early Stage Dementia
Mild cognitive impairments are usually observed in patients with early-stage dementia. Memory and concentration problems start to become obvious to family and coworkers. At this stage, patients tend to have difficulty with:
- traveling to new locations
- remembering names of people they just met
- planning or organizing things
- remembering the whereabouts of a valuable object
- remembering certain words
- retaining information they just read
You May Like: What Is The Difference Between Dementia And Senility
The Hamilton Depression Rating Scale
The Hamilton Depression Rating Scale is one of the most commonly used depression rating scales. It requires 2030 min of questions in a semi-structured interview by a trained interviewer, and is therefore unlikely to be used in people with dementia. It is commonly used in antidepressant drug trials, and like MADRS, has a preponderance of psychological rather than physical items.
Very Mild Impairment Or Normal Forgetfulness
Alzheimers disease affects mainly older adults, over the age of 65 years. At this age, its common to have slight functional difficulties like forgetfulness.
But for stage 2 Alzheimers, the decline will happen at a greater rate than similarly aged people without Alzheimers. For example, they may forget familiar words, a family members name, or where they placed something.
Caregiver support: Symptoms at stage 2 wont interfere with work or social activities. Memory troubles are still very mild and may not be apparent to friends and family.
Also Check: Alzheimer Ribbon Color
What Does Stage 4 Look Like
Stage 4 is when most individuals with dementia are diagnosed because signs of cognitive impairment become glaringly evident. The individual starts forgetting recent or major events, or has trouble remembering what month or year it is. While individuals still have a good level of independence at this stage and can remember things like their phone number, address and basic tasks, it becomes increasingly difficult for them to handle things like paying bills or fixing meals. At this stage, the senior is considered to be in the early stages of dementia.
What Is The Fast Scale
FAST stands for Functional Assessment Staging Tool. This scale was developed by Dr. Barry Reisberg, who is a leading expert in Alzheimers disease. Its used to help doctors, medical professionals and family members understand, talk about and follow the progression of dementias such as Alzheimers disease.
Also Check: Dementia Color Ribbon
Predictive Ability Of The Global Cdr Score Using Receiver Operating Characteristic Curve Analysis
We performed receiver operating characteristic curve analysis to investigate the sensitivity and specificity of the total ABC-DS score for discriminating the severity of AD defined by the Global CDR. We identified the most appropriate thresholds for the total ABC-DS score to discriminate AD severity using the R 3.1.0 statistical software with the ROCR package .
The sensitivities and specificities at the thresholds were for CDR 0/0.5 versus 1/2/3, CDR 0/0.5/1 versus 2/3, and CDR 0/0.5/1/2 versus 3. In this analysis, we defined that the test is positive if the total ABC-DS scores were above the threshold. The sensitivity and specificity were described as P and P, respectively, where P indicates the probability of a correct discrimination that the test diagnosed is X when the patient is truly at X X could be negative or positive.
The Stages Of Dementia According To Fast
1 – No cognitive decline – Your loved one doesn’t have difficulty with memory or learning.
2 – Very mild cognitive decline – The individual misplaces objects and forgets places or names they once knew well, but they can still function independently.
3 – Mild cognitive decline – The person has trouble with organizational skills and making plans.
4 – Moderate cognitive decline – Your loved one struggles to perform complex tasks like dealing with money. Making plans becomes more challenging.
5 – Moderately severe cognitive decline – At this level on the FAST Scale, the person living with dementia cannot survive without help, and they don’t know current events or time.
6 – Severe cognitive decline – A person with this level of dementia cannot dress, bathe or use the restroom without assistance.
7 – Very severe cognitive decline – Someone at this stage on the FAST Scale speaks only a few words a day and needs help to move their body.
Read Also: What Color Ribbon Is Alzheimer’s
What Are The Signs Of Someone Actively Dying
The signs and symptoms of active dying include:
- Long pauses in breathing patients breathing patterns may also be very irregular.
- Blood pressure drops significantly.
- Patients skin changes color and their extremities may feel cold to the touch.
- Patient is in a coma, or semi-coma, or cannot be awoken.
The Montgomery Asberg Depression Rating Scale
The Montgomery Asberg Depression Rating Scale takes about 1520 min for a trained assessor to complete. It is useful among older patients in that mainly psychological rather than confounding physical symptoms are assessed. It is particularly sensitive to change and often used in interventional research but the same issues as with GDS will limit its usefulness outside mild dementia.
Also Check: What Is The Difference Between Dementia And Senility
How Do You Comfort Someone With Dementia
Provide plenty of reassurance and comfort, both in words and in touch. Try distracting with a snack or activity. Avoid reminding them that they just asked the same question. Try ignoring the behavior or question, and instead try refocusing the person into an activity such as singing or helping you with a chore.
Prognostic Indicators Of 6
Identified prognosticators of 6-month mortality varied greatly between studies . However, at least one factor relating to nutrition, nourishment, and/or eating habits was identified as a significant prognostic indicator in all studies, including decreased appetite, insufficient food intake,, malnutrition,, and weight loss.,, Anorexia was strongly and significantly associated with increased mortality within 6 months in multiple studies,,, and dry mouth, which impairs the ability to swallow, was found to be significantly associated with nearly doubled risk of mortality.
Prognostic indicators of 6-month mortality identified in examined literature.
Also Check: Shampoos That Cause Alzheimer’s Disease
Contact Pathways Home Health And Hospice
If someone you love is moving through the FAST scale, our hospice care team can help you make decisions about their care while they still have the ability for input. Its our goal to ensure those wishes are honored when the time comes. Contact us at 888-755-7855 to learn how we can help you and your family navigate and understand the FAST scale as it pertains to your loved ones hospice journey.
What Does Stage 5 Look Like
In Stage 5, the person with dementia has progressed to the middle stage and can no longer live independently. They can still perform some basic tasks, such as being able to feed themselves, but someone else has to prepare the meals for them. At this stage, problematic behaviors can start to occur, such as confusion, wandering, hallucinations and suspiciousness. The person with dementia will require a full-time caregiver and will become more and more dependent.
Also Check: Does Meredith Have Alzheimer’s
What Does Stage 2 Look Like
The second stage of the FAST Scale is defined as normal aged forgetfulness. This manifests in memory lapses like forgetting the name of acquaintances or misplacing items like car keys or glasses. Individuals may experience some difficulty concentrating and sometimes struggle to find the right words. According to experts, Stage 2 can also be considered normal for senior adults.
The Seven Stages Of Fast
The FAST scale is the most well-validated measure of the course of Alzheimers disease in published scientific literature. The scale is comprised of the following seven categories, with the first five being:
Category six is divided into sub-stages and involves difficulties with everyday activities such as dressing and bathing. Those sub-stages include:
Once stage seven hits, the patient starts to lose the ability to speak and move. Those sub-stages are:
Don’t Miss: Alzheimer’s Association Colors
Fast Score Hospice Criteria
In most cases, a person will not qualify for hospice services unless they have a life expectancy of six months or less. In the case of dementia, patients will not usually qualify until they reach stage 6 or 7. However, many people with dementia have other conditions that limit their life expectancy. This means that a person with dementia may be eligible for hospice services before their dementia has progressed into its final stages. Here are some of the conditions that may affect a patients hospice eligibility:
- Aspiration pneumonia
- Difficulty getting adequate hydration or calorie intake
- Pyelonephritis
- Bedsores in stages three or four
- Other conditions that impact life expectancy
A Look At The Hospice Dementia Fast Scale
Every September marks World Alzheimers Month, an annual international campaign designed to raise awareness and challenge the stigma that surrounds dementia. In honor of World Alzheimers Month in general and World Alzheimers Day specifically on September 21, we explore the importance of the Fast Scale, or Reisberg Functional Assessment STaging scale which helps doctors, patients, and their loved ones discuss and understand the progress of Alzheimers disease and dementia. If your loved one is in hospice and suffering from dementia in San Mateo and elsewhere, chances are you will hear mention of this scale at some point within meetings with the care team.
FAST includes a seven-stage system that is based on the persons level of functioning and daily activities. However, FAST focuses more on an individuals level of functioning and activities of daily living rather than cognitive decline. So, its possible for someone to be at a different cognitive stage and have different functionally , according to Dementia Care Central.
The FAST scale happens to be the most well-validated measure of the course of Alzheimers disease in published scientific literature.
Don’t Miss: Alzheimers Awareness Ribbons
Stage : Mild Dementia
Its at this stage that patients start to show symptoms of moderate cognitive decline. Stage 4 patients are presumed to have a mental age of 8 to 12 years old. Their cognitive deficiencies are now apparent to everyone including medical professionals. Some of the activities they might find a challenge include:
- counting money
- handling personal finances
- remembering personal information
The patient will also have difficulty performing complex tasks like planning dinner for guests. They may also appear withdrawn during mentally and socially challenging situations.
Stage : Moderately Severe Dementia
At this stage, the patient usually exhibits obvious severe cognitive decline. This is divided into five different substages:
The patient may also start to exhibit significant personality changes. As their condition declines, they may also:
- lose awareness of their surroundings and recent experiences
- recall their personal history inaccurately
- forget the names of people they know so well like their spouse or children
- have an irregular waking/sleeping cycle
- tend to wander and become lost
Recommended Reading: What Color Ribbon Is Alzheimer’s