End Stage Dementia

The patient has dementia, which has progressed to:

• Stage seven or beyond according to the Functional Assessment Staging Scale
• Unable to ambulate without assistance
• Unable to dress without assistance
• Unable to bathe without assistance
• Urinary and fecal incontinence, intermittent or constant
• No meaningful verbal communication, stereotypical phrases only, or ability to speak is limited to six or fewer intelligible words and
• Patients must have had one of the following within the past 12 months:
  • Aspiration pneumonia
  • Pyelonephritis or other upper urinary tract infection
  • Septicemia
  • Decubitus ulcers, multiple, stage 3 – 4
  • Fever, recurrent after antibiotics
  • Inability to maintain sufficient fluid and calorie intake with 10% weight loss during the previous six months or serum albumin < 2.5 gm/dL