CHESS Scale (interRAI health instability)
interRAI CHESS scale (Hirdes, J Am Geriatr Soc 2003): signs/symptoms counted and capped at 2, plus one point each for decline in decision-making, decline in ADL status, and an end-stage prognosis — a 0–5 health-instability score.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Vomiting
- Yes
- Dyspnea
- Yes
- End-stage disease, prognosis ≤ 6 months
- Yes
Result: CHESS score 3/5: substantial health instability — higher scores indicate greater health instability and mortality risk.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Interpretation
- higher scores mark greater health instability and mortality risk. A care-planning marker, not a prediction of an individual’s death.
What you enter
- Vomiting
- Peripheral edema
- Dyspnea
- Weight loss
- Dehydration
- Leaving ≥ 25% of food uneaten at most meals
- Decline in cognition / decision-making
- Decline in ADL status
- End-stage disease, prognosis ≤ 6 months
How this is calculated
- Scoring
- count signs/symptoms present (vomiting, edema, dyspnea, weight loss, dehydration, low intake), capped at 2; +1 each for decline in decision-making, ADL decline, end-stage disease (≤6 mo) = 0–5.
Hirdes JP, Frijters DH, Teare GF. The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people. J Am Geriatr Soc. 2003;51(1):96-100. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.