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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

Financial Disclosure: Dr Cherney works for a hospice organization.

Clare L. Cherney, MD
ccherney@crsol.com
VITAS Innovative Hospice Care
Waterbury, Connecticut

1. Mitchell SL. A 93-year-old man with advanced dementia and eating problems. JAMA. 2007;298(21):2527-2536. FREE FULL TEXT 2. LCD for Hospice Alzheimer's Disease & Related Disorders. Associated Hospital Service; Medicare RHHI contractor for Northeast region. http://www.ahsmedicare.com/files/documents/021706%20Hospice%20Alzheimers%20Disease%20Related%20Disorders%20L21415.pdf. Accessed January 24, 2008.

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;299(15):1774.

RELATED ARTICLE

A 93-Year-Old Man With Advanced Dementia and Eating Problems
Susan L. Mitchell
JAMA. 2007;298(21):2527-2536.
ABSTRACT | FULL TEXT  

RELATED LETTER

Determining Hospice Benefit for Patients With Dementia—Reply
Susan L. Mitchell
JAMA. 2008;299(15):1774-1775.
EXTRACT | FULL TEXT