cancer, AIDS, major stroke, or heart, renal or liver failure. Functional Assessment Staging Even severely demented patients may have a prognosis of up to two years. Survival time depends on variables such as the incidence of comorbidities and the comprehensiveness of care. The patient should be at or beyond Stage Seven of the Functional Assessment Staging 66 Scale (see Appendix IV ). The factors listed below should be understood explicitly, since many patients do not progress in an orderly fashion through the substages of Stage 7. Also see Appendix V, "Typical Time Course of Alzheimer's Disease," for a pictorial representation of the continuum of dementia. 67 The patient should show all of the following characteristics: Unable to ambulate without assistance. This is a critical factor . Recent data indicate that patients who retain the ability to ambulate independently do not tend to die within six months, even if all other criteria for advance dementia are present. 68 Unable to dress without assistance. Unable to bathe properly. Urinary and fecal incontinence. Occasionally or more frequently, over the past weeks. Reported by knowledgeable informant or caregiver. Unable to speak or communicate meaningfully. Ability to speak is limited to approximately a half dozen or fewer intelligible and different words , in the course of an average day or in the course of an intensive interview. Presence of Medical Complications. The presence of medical comorbid conditions of sufficient severity to warrant medical treatment, documented within the past year, whether or not the decision was