To be eligible for hospice beneficiaries with Alzheimer’s ...

To be eligible for hospice beneficiaries with Alzheimer’s disease must have a FAST Scale of greater than or equal to 7 FAST Scale Items:

Stage 1: No difficulty, either subjectively or objectively

Stage 2: Complains of forgetting location of objects; subjective work difficulties

Stage 3: Decreased job functioning evident to coworkers; difficulty in traveling to new locations

Stage 4: Decreased ability to perform complex tasks (e.g., planning dinner for guests, handling finances)

Stage 5: Requires assistance in choosing proper clothing

Stage 6: Decreased ability to dress, bathe, and toilet independently;

Sub-stage 6a: Difficulty putting clothing on properly

Sub-stage 6b: Unable to bathe properly; may develop fear of bathing

Sub-stage 6c: Inability to handle mechanics of toileting (i.e., forgets to flush, does not wipe properly)

Sub-stage 6d: Urinary incontinence

Sub-stage 6e: Fecal incontinence

Stage 7: Loss of speech, locomotion, and consciousness:

Sub-stage 7a: Ability to speak limited (1 to 5 words a day)

Sub-stage 7b: All intelligible vocabulary lost

Sub-stage 7c: Non-ambulatory

Sub-stage 7d: Unable to sit up independently

Sub-stage 7e: Unable to smile

Sub-stage 7f: Unable to hold head up

Documentation of specific secondary conditions (i.e. Pressure Ulcers, UTI,  Dysphagia, Aspiration Pneumonia) related to Alzheimer’s Disease will support eligibility for hospice care. 

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Contributed by

Giselle Falconi, MD
Giselle is passionate about health care disparities, interprofessional education and culturally competent care. She is originally from Peru and is interested in pursuing a fellowship in Geriatric Medicine after residency.

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