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Functional Assessment Staging Tool (FAST Scale) for Dementia

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The functional assessment staging tool (FAST) is a reliable measure commonly used to assess functional status in patients with dementia. It provides an efficient and comprehensive evaluation of functional ability and the potential for a functional decline over time. This makes it an invaluable tool for healthcare professionals, carers, and family members to monitor the functional abilities of individuals with dementia.

woman puts arm around patient while discussing the functional assessment staging tool for dementia
At Compassus, we use the FAST to assess the functional status of individuals with dementia and determine appropriate care plans. This assessment is completed by a healthcare professional experienced in dementia care and provides an overall score. To learn more about the functional assessment staging tool for dementia, contact us at 833.380.9583. We can provide more information and discuss the FAST score in more detail.

What Is the Fast Scale for Dementia?

One of the ways to determine whether a loved one is experiencing dementia is the functional assessment staging scale. FAST, which Dr. Reisberg developed in 1982, is a practical, functional assessment tool used to define and grade all forms of dementia. It includes seven steps:
  1. No functional or cognitive impairment
  2. Early functional changes
  3. Mild functional losses
  4. Moderate functional losses
  5. Moderately severe functional losses
  6. Severely impaired functional abilities
  7. Total dependence

The functional assessment tool evaluates functional abilities, including physical functional abilities (dressing and grooming), functional language abilities (memory and recognition), functional activities such as mobility or feeding themselves, and many other tasks.

The FAST scale helps families concerned about Alzheimer’s and other dementias identify how far along their loved one is in cognitive decline over time. Understanding an individual’s functioning level can provide information for planning the individual’s care needs accordingly. It also allows caregivers to measure changes in functional status over time at its earliest stages with the most accurate results possible.

Navigating the Fast Score for Dementia

The FAST Scale for Dementia is also known as the Reisberg Functional Assessment Staging Scale. Copyright 1984 by Barry Reisberg, M.D.
  • 1 – No difficulty either subjectively or objectively
  • 2 – Complains of forgetting the 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, difficulty marketing, etc.)
  • 5 – Requires assistance in choosing proper clothing to wear for the day, season, or occasion (e.g., a patient may wear the same clothing repeatedly unless supervised)*
  • 6a – Improperly putting on clothes without assistance or prompting (e.g., may put street clothes on overnight clothes, put shoes on wrong feet, or have difficulty buttoning clothing) occasionally or more frequently over the past weeks*
  • 6b – Unable to bathe properly (e.g., difficulty adjusting bathwater temp.) occasionally or more frequently over the past weeks*
  • 6c – 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*
  • 6d – Urinary incontinence occasionally or more frequently over the past weeks*
  • 6e – Fecal incontinence occasionally or more frequently over the past weeks*
  • 7a – Ability to speak limited to approximately a half-dozen different intelligible words or fewer in an average day or the course of an intensive interview
  • 7b – Speech ability is limited to using a single intelligible word on an average day or in an intensive interview (the person may repeat the word over and over)
  • 7c – Ambulatory ability is lost (cannot walk without personal assistance)
  • 7d – Cannot sit up without assistance
  • 7e – Loss of ability to smile
  • 7f – Loss of ability to hold head up independently

*Scored primarily based on information obtained from a knowledgeable informant

Understanding a FAST Assessment

A FAST assessment, or functional assessment staging tool for dementia, is invaluable in helping caregivers assess the functional abilities of individuals with dementia and assisting in providing appropriate care. It’s a simple yet incredibly effective way to evaluate patients’ functional ability to allow for a better quality of life.

This scale allows caregivers and healthcare providers to track functional progress over time and establish goals that can help improve patient care. Understanding the FAST Assessment provides valuable insight into dementia patients and will ultimately help lead to better outcomes throughout the disease process.

Using the FAST Score for Hospice Care

Recently released, the FAST Score has been making waves in hospice and home care. This functional assessment staging tool for dementia can offer tremendous support to those tasked with providing care to patients with Alzheimer’s or related dementia. It helps by offering a unique, problem-solving approach to provide more tailored care plans. The FAST Score uses custom scoring for functional tasks such as dressing and eating to evaluate which nursing interventions are needed for each patient. Most importantly, it enables caregivers to quickly adjust patient care when needs change suddenly—giving them the information they need to make well-informed decisions swiftly.

Learn More About FAST for Dementia at Compassus

At Compassus, we understand how difficult it can be to care for a loved one with dementia. That is why we use the functional assessment staging tool to evaluate the functional status and create personalized care plans for each patient. If you want to learn more about FAST and how it can help your loved one, please contact us at 833.380.9583.