LCD Guideline
Dementia due to Alzheimer’s Disease and Related Disorders
Patients will be considered to be in the terminal stage of dementia (life expectancy of six months or less) if they meet the following criteria. Patients with dementia should show all the following characteristics:
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Patients should have had one of the following within the past 12 months:
Note: This section is specific for Alzheimer’s Disease and related disorders, and is not appropriate for other types of dementia, such as multi-infarct dementia.
Comparative Data
Fast Score - Document on continually, on admit Fast 7a now 7c
PPS/ADL - PPS score change, 1 month ago PPS 50% now PPS 30%. Patient was two-person transfer, now Hoyer lift Intake change - Was eating 100% of meals now only eats 50% meals. Patient pocketing food. Diet change from regular to pureed. Patient was eating independently now needs assistance
Weight Change - lost 10lbs in last month, in last 6 months has lost 10% of body weight
Alertness/Orientation - On admission patient was sleeping 10 hours a day, now sleeping 15+ hours a day
Skin issues
- should be documented on every visit. Redness noted to coccyx, previously had no skin issues
Activity
- Can no longer propel him/herself in wheelchair, on admission could propel around independently. Need for lateral supports, patient now leaning in wheelchair and needs support laterally.
New infections, Recurrent Infections
Fever noted, recurrent fever
Comorbidities
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