Hospice and Palliative Care
Functional Assessment Staging
Limited Speech Ability Functional Assessment Staging (Fast)
1. No difficulty either subjectively or objectively.
2. Complains of forgetting location of objects. Subjective work
    management rather than curative treatment difficulties.
3. Decreased job functioning evident to co-workers. Difficulty in
    traveling to new locations. Decreased organizational capacity.*
4. Decreased ability to perform complex tasks, e.g. planning dinner
    for guests, handling personal finances (such as forgetting to
    pay bills), difficulty marketing, etc.
5. Requires assistance in choosing proper clothing to wear for the
    day, season or occasion, e.g. patient may wear the same clothing
    repeatedly, unless supervised.*
6. A) Improperly putting on clothes without assistance or prompting
    (e.g. may put street clothes on over night clothes, or put shoes on
    wrong feet, or have difficulty buttoning clothing) occasionally
    or more frequently over the past weeks.*
    B) Unable to bathe properly (e.g., difficulty adjusting bath-water
    temp.) occasionally or more frequently over the past weeks.*
    C) Inability to handle mechanics of toileting (e.g., forgets to flush
    the toilet, does not wipe properly or properly dispose of toilet
    tissue) occasionally or more frequently over the past weeks.*
    D) Urinary incontinence (occasionally or more frequently
    over the past weeks).*
    E) Fecal incontinence (occasionally or more frequently
    over the past weeks).*
7. A) Ability to speak limited to approximately a half dozen
     intelligible different words or fewer, in the course of an average
    day or in course of an intensive interview.
    B) Speech ability is limited to the use of a single intelligible
    word in an average day or in the course of an intensive interview
    (the person may repeat the word over and over).
    C) Ambulatory ability is lost (cannot walk without personal
    assistance).
    D) Cannot sit up without assistance.
    E) Loss of ability to smile.
    F) Loss of ability to hold head up independently.
*Scored primarily on the basis of information obtained from knowledgeable informant.
Long-Term Care