Specialized Home Care » Health » What is a FAST Scale?

What is a FAST Scale?

What is fast scale?

FAST stands for Functional Assessment Staging Tool. It is a standardized measure used in psychiatry and geriatric care to evaluate the functional decline of patients. It was introduced by Barry Reisberg. It is mostly used for patients with Alzheimer’s or other forms of dementia. It assesses the person’s ability to perform daily activities and tasks. The scale typically ranges from Stage 1 (normal functioning) to Stage 7 (severe cognitive decline). It provides healthcare professionals and caregivers with valuable insights. It helps them to understand the patient’s cognitive and functional status.

If dementia has entered your life, whether personally or through someone you know, you’ve likely come across the concept of its different “stages.” These stages act as markers. They help us understand how the disease is advancing in both the mind and body. They offer valuable insights to caregivers, healthcare professionals, and families. They enable them to grasp the current situation and prepare for what lies ahead in a more informed way. FAST helps in understanding those stages.

At Specialized Home Care, we understand how difficult dementia can be. For us, the FAST scale plays a crucial role in understanding the functional abilities of individuals with dementia. Every patient has different symptoms. Our skilled healthcare experts in dementia care conduct this thorough assessment. It results in a well-rounded score. To delve deeper into this tool, continue reading.

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How does FAST scale work?

Fast Scale works in a very interesting way. It was developed by Dr.Reisberg in 1982. It focuses on cognitive decline and breaks down the phases into different categories. It has the following seven stages:

  • Stage 1: Normal adult; No functional or cognitive impairment
  • Stage 2: Normal older adult; Early functional losses
  • Stage 3: Early dementia; Difficulty with complex tasks
  • Stage 4: Mild dementia; Frequent forgetfulness
  • Stage 5: Moderate dementia; Cannot live independently
  • Stage 6: Moderately severe dementia; 24/7 supervision
  • Stage 7: Severe dementia; Final Stage


The scale assists in comprehending the progression of the disease. Not only that but helps in tailoring appropriate care strategies. Here’s how it works:

  • Stages of Decline: It has seven stages, from normal function to severe decline.
  • Daily Tasks: Measures ability in tasks like dressing, bathing, etc.
  • Expert Assessment: Healthcare professionals experienced in dementia assign a stage.
  • Overall Score: Generates an overall score for care planning.
  • Personalized Care: Guides tailored care plans for each stage.
  • Understanding Change: Helps families grasp cognitive changes.
  • Future Planning: Prepares for future challenges and adjustments.


How do you calculate FAST score?

The FAST score can be calculated using the seven stages described above. Healthcare professionals use the seven categories and assign the patients to different categories. Depending on the condition of the dementia patient, the category is selected. Here’s how it is calculated:

  • Tasks Assessment: Evaluate daily activities like dressing, bathing, eating, etc.
  • Compare Abilities: Match observed abilities to descriptions in each stage.
  • Assign Stage: Choose the stage that closely aligns with observed abilities (1 to 7).
  • Reassess Periodically: Adjust stage as abilities change over time.
  • Numerical Score: Each stage corresponds to a score, reflecting overall functional level.

At Specialized Home Care, we make sure to test our patients thoroughly, leaving no room for error. We use this test to see how well a patient can perform everyday tasks.


What are the benefits of FAST scale?

There are many benefits of FAST scale. According to the Alzheimer’s Association, over 6 million Americans of all ages have Alzheimer’s. Caring for someone with dementia is laden with challenges. It requires substantial time and often takes an emotional toll. The FAST scale streamlines this intricate journey for caregivers. It offers a well-defined route ahead. By facilitating an evaluation of the patient’s condition, it ensures that caregivers’ actions harmonize precisely with the individual’s distinct needs. Here are some benefits of the FAST scale:

  • Structured Assessment: Offers a systematic way to assess functional abilities.
  • Clear Progression: Defines stages of decline from normal to severe.
  • Standardized Comparison: Provides a common framework for healthcare professionals.
  • Informed Care Planning: Guides tailored care strategies for each stage.
  • Effective Communication: Enables clear communication among caregivers and medical teams.
  • Realistic Expectations: Helps families understand and anticipate changes.
  • Proactive Interventions: Facilitates early interventions for optimal care.
  • Predict Future Needs: Helps in anticipating future challenges and planning ahead.
  • Individualized Support: Tailors assistance to the person’s current capabilities.
  • Quality of Life: Enhances well-being through appropriate support.
  • Care Consistency: Ensures consistent care across different caregivers.
  • Empowerment: Empowers families with the knowledge to make informed decisions.
  • Long-Term Planning: Facilitates long-term care and end-of-life discussions.


What is the scoring criteria for FAST scale?

There are particular scoring criteria for FAST scale. It follows a seven-stage system. Depending on those stages, a score is provided.

  • Stage 1: No functional decline. Normal, independent functioning.
  • Stage 2: Very mild decline. Occasional forgetfulness, normal daily activities.
  • Stage 3: Mild decline. Noticeable memory lapses, and difficulties in complex tasks.
  • Stage 4: Moderate decline. Decreased independence in daily tasks, challenges with finances, and planning.
  • Stage 5: Moderately severe decline. Assistance needed for dressing and bathing, confusion about time and place.
  • Stage 6: Severe decline. Assistance needed for most activities, and personality changes.
  • Stage 7: Very severe decline. Complete dependence, limited speech.

There is no particular time period for these stages. For some patients, the timing between these stages may be short. For others, it might be a lot longer. Some of the stages may also overlap. It is just an easy and systematic way of determining which stage a patient is in. Dementia can be an overwhelming condition. By 2050, it is estimated that 14 million individuals in the US will have this condition. Therefore, tests like this help in understanding this condition more.


What is the FAST score for hospice dementia?

The FAST score for hospice dementia is usually stage 7. For some patients, it can also be in stage 6. These stages signify a significant level of functional decline and cognitive impairment. In Stage 6, individuals often require substantial assistance with daily activities. Moreover, personality changes may become more pronounced. In Stage 7, patients are usually completely dependent on caregivers. They have limited speech and minimal ability to communicate. The choice of hospice care indicates that the patient’s condition has progressed to a point where comfort is a paramount consideration. Hospice care providers tailor their approach to ensure the patient’s comfort in this advanced stage of dementia.

At Specialized Home Care, we do everything to make sure that our patients get the appropriate care needed. Dementia is difficult for both the patient and their families. Therefore, we ensure that our care facilities have the capacity to provide optimal care. Here is what we have to offer:

  • Customized Care: We focus on comfort and quality of life in advanced stages.
  • Functional Assessment: FAST score helps determine appropriate care strategies.
  • Patient-Centered Approach: Tailors care to individual needs and conditions.
  • Comfort and Dignity: We ensure patient comfort and maintain dignity.
  • Clinical Assessment: Healthcare professionals assess and assign the appropriate stage.
  • Holistic Care: Consider physical, emotional, and psychological well-being.


Can you skip stages on FAST scale?

No, you cannot skip stages on FAST scale. People with Alzheimer’s disease do not skip stages. Instead, they move through them differently based on their situation. Keeping track of their specific stage progression helps families and healthcare professionals anticipate what to expect next. It also helps to determine the best healthcare plan for the patient. Here are a few things to remember:

  • Continuous Progression: The FAST scale stages represent a gradual continuum of dementia-related decline.
  • Blended Characteristics: In some cases, individuals might show a mix of features from adjacent stages.
  • Clinical Judgment: Healthcare professionals may use their judgment to assign the most fitting stage.
  • Accurate Reflection: The goal is to ensure the assigned stage accurately represents the individual’s status.


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