Hospice Criteria for Dementia:
Palliative Performance Score (PPS) ≤ 70% (see table below)
Dependence on assistance for 2 or more activities of daily living (e.g. feeding, transferring, ambulation, bathing, continence, dressing)
A documented specific dementia diagnosis (e.g. Alzheimer’s Disease, senile degeneration of the brain, Lewy Body Dementia, etc.)
Stage 7 or beyond according to the Reisberg Functional Assessment Staging (FAST) Scale:
Difficulty putting clothing on properly
Unable to bathe properly; may develop fear of bathing
Inability to handle mechanisms of toileting
Urinary incontinence
Fecal incontinence
Loss of speech, locomotion, limited ability to speak
Patient should have had one (1) of the following within the past 12 months:
Aspiration pneumonia
Pyelonephritis or other upper urinary tract infection
Septicemia
Decubitus ulcers
Fever recurrent after antibiotics
Difficulty swallowing
Inability to maintain sufficient fluid and calorie intake with 10% weight loss during the previous six months or serum albumin < 2.5 gm/dl
BMI below 22 kg/m2 within past 6 months
Systolic B/P less than 90 or progressive postural hypotension
