The Palliative Performance Scale describes functional status in palliative care across eleven levels, from 100% down to 0%, using five dimensions: ambulation, activity and evidence of disease, self-care, oral intake, and level of consciousness.
It is used to communicate functional status concisely between team members, to support decisions about care setting and service eligibility, and to track decline over time. This page explains how the levels are structured and how to read across them; it is a reference guide, not the instrument itself.
Zdrovia — https://www.zdrovia.ca/resources/palliative-performance-scale/
Functional Assessment
PPS Level Reference
Select a level to see how the five dimensions combine at that percentage, and how it compares with a previous assessment.
Levels are assigned in increments of 10%. Intermediate values such as 55% are not part of the scale.
Compare with a previous assessment
Transitional range
Progressive reduction in mobility and increasing dependence for self-care. This is typically where care needs escalate fastest and where care-setting decisions are revisited.
The five dimensions at this level
Ambulation
Highest priorityMainly sitting or lying
Activity & evidence of disease
High priorityUnable to do any work, extensive disease
Self-care
Moderate priorityConsiderable assistance required
Intake
Lower priorityNormal or reduced
Level of consciousness
Lower priorityFull, or periods of confusion
About the instrument
The Palliative Performance Scale version 2 is copyrighted by Victoria Hospice Society, which makes it available for clinical use on condition that the copyright notice is retained and the instrument is not altered. The descriptions above are a practitioner reference written in our own words — take the definitive wording of each level from the official version rather than from any summary, including this one.
These results are estimates based on published clinical data and are for informational purposes only. They do not constitute medical advice, a diagnosis, or a treatment recommendation. Consult a licensed aesthetic practitioner before beginning any treatment. Individual results vary.
Zdrovia records serial PPS scores per patient, so decline across weeks is visible at a glance instead of buried in the notes. See how smart blocks work →
Track PPS trajectory on the chart
Zdrovia records serial PPS scores per patient, so decline across weeks is visible at a glance instead of buried in the notes.
Reading across the five dimensions
Each level is defined by a combination of the five dimensions, and the guidance is to read the row from left to right, giving priority to the leftmost columns. Ambulation and activity carry more weight in determining the level than intake or consciousness.
Patients frequently do not fit a single row cleanly — someone may have the ambulation of one level and the intake of another. The convention is to assign the level that best matches overall, resolving ties in favour of the leftmost columns rather than averaging across dimensions.
Levels are assigned in increments of 10%. Intermediate values such as 55% are not part of the scale, and inventing them makes scores incomparable between assessors and across time.
What the bands broadly indicate
The 100% to 70% range describes people who remain ambulatory, with declining ability to carry out normal work or activity as the percentage falls. The 60% to 40% range describes progressive reduction in mobility and increasing need for assistance with self-care. Below 40%, patients are largely or entirely bed-bound with reduced intake and, at the lower levels, reduced consciousness.
Lower scores are associated with shorter survival across many studies, but the relationship is statistical and population-level. The scale describes current function; it is not a prognostic instrument for an individual, and using a single reading to predict a specific person's remaining time is a misuse of it.
Using it as a repeated measure
A single PPS level tells you where someone is now. A series tells you how quickly they are changing, which is usually the more useful clinical information — the same 50% means something different in a patient who was 80% a fortnight ago and one who has been stable for months.
That makes it worth recording levels as structured, timestamped values that can be compared, rather than as a number mentioned in the body of a note. The trajectory is the finding.
About the instrument
The Palliative Performance Scale version 2 is copyrighted by Victoria Hospice Society, which makes it available for clinical use on the condition that the copyright notice is retained and the instrument is not altered. The definitive wording of each level should be taken from the official version rather than from any summary, including this one.
This page describes the structure of the scale and how the levels are interpreted in its own words, as a reference for practitioners who already use it. It is not a reproduction of the instrument and is not a substitute for the official version.