Last updated: April 13, 2026
Developed by Dr. Alice Villalobos, the HHHHHMM scale evaluates 7 factors: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days Than Bad. Each is scored 0–10. A total ≥35/70 is considered acceptable quality of life.
10 = no pain, 0 = severe unmanaged pain
10 = eating well, 0 = refuses all food
10 = well hydrated, 0 = severely dehydrated
10 = clean and groomed, 0 = soiled, pressure sores
10 = alert, playful, 0 = withdrawn, anxious
10 = moves freely, 0 = unable to move
10 = all good days, 0 = all bad days
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