If you or a person you know have been diagnosed with dementia, the disease may be talked about in terms of “stages.” These various stages are employed to indicate how far along the disease has gone and what is presently occurring to their body and brain. This serves to inform the caregivers, healthcare providers and loved ones about what is going on with their family member and help them prepare them for what is going on right now and down the road.
There are a number of various scales memory care professionals utilize to assess the progress of a person’s dementia. The Global Deterioration Scale (GDS), the Clinical Dementia Rating (CDR) and the Functional Assessment Staging Test (FAST) are most widely utilized scales. Each of these instruments has a unique system of assessing the stage and severity of a person’s mental decline.
What is the FAST Scale?
FAST is the acronym for Functional Assessment Staging Tool. This scale was originally created by Dr. Barry Reisberg, a renowned physician specializing in Alzheimer’s disease. It’s designed to assist physicians, medical experts and family members in comprehending, discussing and adhering to the course of dementias like Alzheimer’s disease.
What does the FAST scale measure for an individual?
In contrast to other scales that are mainly concerned with cognitive impairment, like the GSD, FAST is concerned with an individual’s capacity to function and carry out activities of daily living.
How does the FAST Scale differentiate the stages of dementia?
You are probably familiar with the three broad phases of dementia: early or mild phase, middle phase and late phase. The FAST scale delves deeper into each of these phases and subdivides them into more understandable and detailed descriptions.
What are the categories of the FAST Scale?
The FAST Scale segments the journey of dementia into seven numbered phases. These are:
- 1 or typically functioning adult
- 2 or normally functioning senior adult
- 3 or early dementia
- 4 or mild dementia
- 5 or mid-stage dementia
- 6 or moderately severe dementia
- 7 or severe (end stages) of dementia
What does Stage 1 look like?
Stage 1 is where a person has no cognitive and functional decline. That is, they are mentally healthy, normal adults of any age. If you are a relative of a person with dementia, you yourself are most likely at Stage 1.
What does Stage 2 look like?
The second of the FAST Scale stages is called “normal aged forgetfulness.” This is present in memory mistakes such as failing to recall a friend’s or acquaintance’s name or losing a set of car keys or spectacles. Others might have difficulty focusing and some trouble with remembering the right word. Stage 2, report experts, may also be called “normal” for older adults.
What about Stage 3?
At this point, the patient begins to exhibit early signs of mild cognitive impairment that become apparent only to intimate friends and relatives. They might begin repeating questions or relating the same story repeatedly. If the patient continues to be employed, their capacity to execute their job will begin to deteriorate. Attention requires more effort, and the individual cannot do unnecessarily complicated tasks such as planning a party or filling out their taxes.
What happens in Stage 4?
Stage 4 is when most people with dementia get diagnosed because indicators of cognitive deficit become glaringly obvious. The person begins forgetting recent or important events, or having difficulty knowing what month or year it is. Although people remain pretty independent at this point and are able to recall details such as their phone number, address and simple tasks, it becomes more challenging for them to manage something like paying bills or preparing meals. At this point, the elder is in the beginning stages of dementia.
What is Stage 5 like?
In Stage 5, the individual with dementia has reached the “middle” stage and is no longer able to live independently. They are still able to do some simple things, such as being able to feed themselves, but another person must prepare the food for them. Problematic behaviors can begin to appear at this stage, such as confusion, wandering, hallucinations and suspiciousness. The individual with dementia will need a full-time caregiver and will become increasingly dependent.io
What is Stage 6 like?
Stage 6 can be viewed as the start of late-stage or advanced dementia. The individual will become so reliant on his or her caregiver that they will need 24/7 care and oversight for nearly everything. They may begin losing their voice and become progressively worse with mobility problems. Many family members and caregivers, at this stage, find it becomes imperative to place the person in a specialist memory care community.
What does Stage 7 consist of?
Stage 7 is the last stage of cognitive disease. The person’s ability to talk will fade and eventually disappear. He or she will lose his or her remaining skills, becoming incontinent and unable to walk. Talking to others will soon be impossible. Eventually, the body will begin to shut down and the person will die.
How can the FAST scale help determine what type of dementia my loved one has?
One interesting thing about the FAST Scale is that, if the individual has Alzheimer’s disease, any changes they experience will be in sequence – that is, FAST stages won’t be skipped over. If the person loses some of the abilities listed at a “later” stage but still maintain abilities from an “earlier” stage (for instance, if they can still get dressed and pick out clothes, but only have mild memory loss, their problems are not caused by Alzheimer’s disease). This is very useful, because it means their condition can be potentially treated.
How long does each FAST stage last?
There is no predetermined length of time for how long an individual will remain in the various stages of FAST. The progression of memory loss is individual to each person, and the length of time they remain in one stage or another varies from person to person.
How does the FAST Scale determine eligibility for hospice services?
Dementia is a terminal and progressive illness, but it is almost impossible to know how long someone will live. Hospice care can be very beneficial for late-stage dementia patients, but most caregivers have no idea that their loved one is eligible for hospice care. If an individual with dementia is at Stage 7 on the FAST Scale, they can usually become qualified for hospice care. The symptoms that the doctors and specialists check for include incontinence, inability to manage the day-to-day tasks of life and being unable to speak for real or to form their own ideas.
Dementia diagnosis is a life-altering one and a frightening experience for all parties involved. Employing the FAST Scale to identify how severe someone’s dementia is may make people feel empowered and be proactive with changes along the course of memory loss.