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


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