An Alzheimer’s diagnosis can turn your life upside down, whether it’s a parent, grandparent, or another loved one developing the condition. Many family caregivers don’t know where to look for answers and support. In addition to speaking with your loved one’s doctor, the FAST Scale can be instrumental in helping you understand how Alzheimer’s disease progresses. While every patient experiences the disease differently, the FAST Scale shows you what to expect.

What Is the FAST Scale?

The Functional Assessment Staging Tool (FAST) measures how Alzheimer’s disease affects a person’s ability to perform daily activities. Unlike cognitive assessments that focus on memory and thinking skills, the FAST Scale evaluates their everyday abilities, such as getting dressed, eating, and bathing. Healthcare providers use the FAST stages to track disease progression and adjust treatment plans, while insurance companies may also reference them when making coverage decisions. Insurance companies reference it for coverage decisions. And not least of all, families rely on it to understand what changes to expect and how they can support their loved one.

The Seven Stages of the FAST Scale

The FAST Scale is broken down into seven stages, with some of those stages divided even further. Here’s a general overview of what to expect from each of the FAST stages:

Stage 1: Normal Adult

This represents the baseline cognitive abilities of most average adults. There is no functional decline, and the person maintains the ability to do all normal activities, especially those involving memory and reasoning.

Stage 2: Possible Mild Cognitive Impairment

Some symptoms of cognitive decline are normal as we age and aren’t cause for immediate concern. If your loved one is sometimes forgetful or occasionally misplaces items, they may fall into this stage. The key here is that cognitive lapses should not interfere with work or social activities.

Stage 3: Mild Cognitive Impairment

Here is where the first noticeable symptoms of Alzheimer’s disease emerge. Your loved one may be unable to complete complex tasks, or they could find themselves lost in familiar places. Other issues characteristic of this stage include difficulty finding work, memory issues, and trouble concentrating.

Stage 4: Mild Alzheimer’s Disease

At the fourth stage, patients begin to lose their independence. Things like managing finances, planning meals, and handling complex tasks become difficult or impossible. Your loved one may withdraw from challenging situations and need help with activities like shopping or managing medications. However, they can still perform basic self-care tasks.

Stage 5: Moderate Alzheimer’s Disease

People entering the fifth stage of the FAST scale for dementia need significant assistance with the activities of daily living. They may not be able to choose their own clothing, remember their personal history, or keep track of time and place. Your loved one may still recognize family members and retain some level of independence with eating and personal hygiene.

Stage 6: Moderately Severe Alzheimer’s Disease

During Stage 6, you may notice personality changes intensifying. Suspicion, delusions, and sleep disturbances frequently occur. Patients at this stage usually require substantial daily assistance but may still recognize familiar faces. Typically, the sixth stage is broken down into these sub-phases:

6a—Difficulty putting on clothing properly
6b—Problems bathing independently
6c—Inability to handle toileting properly
6d—Urinary incontinence
6e—Fecal incontinence

Stage 7: Severe Alzheimer’s Disease

Round-the-clock care is often essential for patients in the seventh stage of the FAST Scale. Like stage 6, this phase is divided into sub-stages dealing with verbal and physical abilities:

7a—Speech limited to about six words per day
7b—Vocabulary reduced to one word
7c—Loss of ability to walk
7d—Inability to sit up without help
7e—Loss of ability to smile
7f—Inability to hold up head

How the FAST Scale and Hospice Are Connected

FAST scoring is a crucial part of determining eligibility and timing for hospice care. If your loved one has dementia or Alzheimer’s disease, they could be eligible for hospice as they reach the later stages and have a prognosis of six months or less. The FAST Scale helps hospice professionals assess the severity of a patient’s condition and ensure they get the proper, personalized end-of-life care.

Here to Support You and Your Loved Ones

No matter how you look at it, an Alzheimer’s diagnosis is overwhelming for both the patient and their family caregivers. However, the FAST Scale is a helpful way to understand the condition in a straightforward way. The team at Agape Hospice & Palliative Care is here to support you as well, should your loved one need hospice care as the disease progresses. Contact us today to learn more about how we help families in Los Angeles and Orange Counties.

Understanding the FAST Scale for Alzheimer’s Disease