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April 16, 2008

Determining Hospice Benefit for Patients With Dementia

JAMA. 2008;299(15):1774-1775. doi:10.1001/jama.299.15.1774-b

To the Editor: In her Clinical Crossroads article, Dr Mitchell1 discussed the problems associated with advanced dementia. The article stated that patients with advanced Alzheimer disease and other related dementias are eligible for the Medicare Hospice Benefit when they reach Functional Assessment Staging (FAST) stage 7c (unable to ambulate independently). However, at least in some geographical areas they are actually eligible for hospice care when they reach FAST stage 7a (speech limited to fewer than 6 intelligible words during an average day).2