Archive for Symptoms

Dementia’s FAST Score

A patient with dementia must have a F.A.S.T. score of seven (7) to qualify for hospice care.

FAST is an acronym for the Reisberg Functional Assessment STaging Scale. A scale nicknamed FAST to determine dementia’s severity is blatantly ironic. As a loved one’s dementia (Alzheimer’s, Lewy Bodies, etc.) worsens, he or she typically becomes, well, slower.

Currently the Reisberg scale (example found here) contains various stages and sub-categories, including these two:

  • Stage 3: Decreased job functioning evident to coworkers; difficulty in traveling to new locations
  • Stage 4: Decreased ability to perform complex tasks (e.g., planning dinner for guests, handling finances)

Those who have cared for someone with dementia usually sense the “slowing down” of a loved one only after he or she has worsened. Read More →

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Hospice and Reflexive Eating

We talked about “reflexive eating” in a hospice meeting.

It’s when nourishment is automatically eaten.

I immediately thought about my next meal.

It’s when opening the mouth for food or liquid is more from habit than need.

I eat too much.

If food is placed before me, I might take a bite or ten without even being hungry. Could I be a reflexive eater? Could I blame this problem on Mom? As a kid, we not only had three nice meals a day, but after school there was usually a plate of cookies. It was such a Leave It To Beaver stereotype, with me home from a grueling day in fourth grade. There, ready for me, were a cool glass of milk accompanied by freshly baked chocolate chip cookies (with walnuts, of course).

There’s more.

What about declining dessert after dinner, but scheming for—while later watching Bonanza or The Twilight Zone on ye olde TV—a bowl of ice cream? One scoop? Two?

What about my lifelong chips and salsa relationship? Read More →

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Ascites and Other Less Obvious Ailments

How easy it can be to downplay our emotional or spiritual anguish.

Occasionally, a nurse at the hospice team meeting will give an incomplete report about a patient. The team leader will prompt the nurse to make sure all the basics are covered. Though my medical knowledge is limited (and that’s a generous assessment), I’ve gone to the meetings long enough to ask a few of the predictable questions . . .

  • Does the patient require oxygen? Is it continuous or as needed?
  • Is he bedbound?
  • What is her F.A.S.T. score?

Because of situations with several recent patients, I’ve added another subject to ask if a nurse forgot to include the information in her overview.

  • Any sign of ascites?

Huh? First, let’s get to the simple, safe stuff: ascites is pronounced uh-site-teez. Read More →

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