Alzheimer’s and Dementia

When to Call Palliative Care

Fast Scale Stage 6*

  • Difficulty dressing

  • Serious difficulties with bathing

  • Inability to toilet properly without help

  • Urinary incontinence

  • Fecal incontinence

When to Call Hospice Care

Fast Scale Stage 7a*

  • Severely limited speech, just a handful of words a day

  • Little to no intelligible speech

  • Unable to walk

  • Unable to sit up without help

  • Unable to smile

  • Unable to hold head up without help

Referral Guidelines

Disease Related Complications such as:

  • Aspiration pneumonia

  • Pyelonephritis or upper urinary tract infection

  • Septicemia

  • Decubitus ulcers, multiple, stage 3-4

  • Fever recurrent after antibiotics

  • Difficulty swallowing or refusal to eat

  • If receiving artificial nutritional support (NG or G-tube, TPN), patient must be exhibiting continued weight loss despite the feedings

  • Protein calorie malnutrition:

  • Weight loss over 11% or BMI<18 or Albumin <3.1

Plus either:

OR Significant Comorbidity such as:

  • Heart Failure

  • Advanced Cancer

  • COPD

If the patient does not meet above guidelines but is still thought to be appropriate for hospice (e.g., has comorbidities, recent rapid decline), please call for an assessment.

LifeTouch Health now offers Telehealth support for patients and their families in nursing homes, inpatient centers, and their homes.

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*SOURCES:

  • Sclan, S. G., & Reisberg, B. (1992). Functional Assessment Staging (FAST) in Alzheimer’s disease: Reliability, validity, and ordinality. International Psychogeriatrics, 1992 (4), Supplement 1:55-69.