Patient Characteristics

Male
Female

PPS SCORE
The Palliative Performance Scale (PPS) rates the patient's functional ability.
The percentage score should be selected for each patient.

This patient %	%	Ambulation	Activity Level Evidence of Disease	Self-Care	Intake	Level of Consciousness
	100	Full	Normal No Disease	Full	Normal	Full
	90	Full	Normal Some Disease	Full	Normal	Full
	80	Full	Normal with Effort Some Disease	Full	Normal or Reduced	Full
	70	Reduced	Unable to do normal job or work Some Disease	Full	Normal or Reduced	Full
	60	Reduced	Unable to do hobbies or housework Significant Disease	Occasional Assistance Needed	Normal or Reduced	Full or Confusion
	50	Mainly sit/lie	Unable to do any work Extensive Disease	Considerable Assistance Needed	Normal or Reduced	Full or Confusion
	40	Mainly in Bed	As above	Mainly Assistance	Normal or Reduced	Full or Drowsy or Confusion
	30	Bed Bound	As above	Total Care	Reduced	Full or Drowsy or Confusion
	20	Bed Bound	As above	Total Care	Minimal Sips	Full or Drowsy or Confusion
	10	Bed Bound	As above	Total Care	Mouth Care Only	Drowsy or Coma
	0	Death	-	-	-	--
		Not reported

FAST SCORE
The Functional Assessment Staging (FAST) scale rates the patient's cognitive ability correlated with the patient's functional ability. FAST is validated as an end-of-life predictor for persons with Alzheimer disease. The numeric score should be selected for each patient, however, inasmuch as it is a useful indicator of the patient's cognitive state.

This patient's score	Score	Level of Disability
	1	No difficulties, either subjectively or objectively.
	2	Complains of forgetting location of objects. Subjective word finding 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 (forgetting to pay bills), difficulty shopping, 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. Difficulty putting clothing on properly without assistance.
		b. Unable to bathe properly; e.g., difficulty adjusting bath water temperature) 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, occasional or more frequently.
		e. Fecal Incontinence, occasional or more frequently.
	7	a. Ability to speak limited to approximately a half dozen different words or fewer, in the course of an average day or in the course of an intensive interview.
		b. Speech ability limited to the use of a single intelligible word in an average day or in the course of an interview (the person may repeat the word over and over.
		c. Ambulatory ability lost (cannot walk without personal assistance).
		d. Ability to sit up without assistance lost (e.g., the individual will fall over if there are no lateral rests [arms] on the chair).
		e. Loss of the ability to smile.
		f. Loss of the ability to hold up head independently.
	Not reported

 

 

DISEASE TRAJECTORY
A 2003 study by researchers at the Rand Corporation sought to explain, organize, and quantify the various "trajectories of chronic illness," in an effort to describe ... the character of aging and dying … the study classified them into the three most common groups, using the trajectory of decline over time that is characteristic of the major type of disease or disability. The first group dies after a short period of evident decline; this is the typical course of death from cancer [or, e.g., fatal stroke or myocardial infarction] … The second group dies following several years of increasing physical limitations, punctuated by intermittent acute life-threatening episodes requiring hospitalization and vigorous intervention; this is the typical course of death from chronic cardiac or respiratory failure … The third-and already the largest-group dies only after prolonged dwindling, usually lasting many years; this is the typical course of death from dementia (including Alzheimer's disease or disabling stroke [or progressive neurodegenerative diseases]) or generalized frailty of multiple body systems.

Select disease trajectory	Disease trajectory
	Not reported

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