Assessment of decision-making capacity in older adults: An emerging area of practice and research

Journals of Gerontology - Series B Psychological Sciences and Social Sciences

Volumn 62, Issue 1, 2007, Pages

  Moye, Jennifer ^a,c   Marson, Daniel C ^b  

^a HARVARD MEDICAL SCHOOL   (United States)

^b The University of Alabama at Birmingham   (United States)

^c VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; CLINICAL ASSESSMENT; COMPETENCE; DECISION MAKING; DEMENTIA; DEMOGRAPHY; GERIATRIC CARE; GERIATRIC PATIENT; GERONTOLOGICAL RESEARCH; HOSPITAL PATIENT; HOSPITALIZATION; HUMAN; INFORMED CONSENT; LONG TERM CARE; MEDICAL DECISION MAKING; MEDICAL ETHICS; MENTAL DISEASE; NURSING HOME PATIENT; PRACTICE GUIDELINE; PRIORITY JOURNAL; SOCIOLOGY; ALZHEIMER DISEASE; ECONOMICS; GERIATRIC ASSESSMENT; LEGAL ASPECT; MENTAL CAPACITY; PSYCHOLOGICAL ASPECT; RESEARCH; REVIEW; UNITED STATES;

AGED; AGED, 80 AND OVER; ALZHEIMER DISEASE; DECISION MAKING; DEMENTIA; ECONOMICS; GERIATRIC ASSESSMENT; HUMANS; INFORMED CONSENT; MENTAL COMPETENCY; RESEARCH; UNITED STATES;

EID: 33947732138     PISSN: 10795014     EISSN: None     Source Type: Journal    
DOI: 10.1093/geronb/62.1.P3     Document Type: Article

References (91)

1. American Bar Association Commission on Law and Aging and American Psychological Association, (2005). Assessment of older adults with diminished capacity: A handbook for lawyers. Washington, DC: American Bar Association.
2. American Bar Association Commission on Law and Aging and American Psychological Association, (in press). Judicial determination of capacity of older adults in guardianship proceedings. Washington, DC: American Bar Association.
3. Anderer, S. J. (1997). Development of an instrument to evaluate the capacity of elderly persons to make personal care and financial decisions. Unpublished doctoral dissertation, Allegheny University of the Health Sciences.
4. Appelbaum, P. S. (1982). Competency to consent to research: A psychiatric overview. Archives of General Psychiatry, 39, 951-958.
5. Appelbaum, P. S., & Bateman, A. (1980). Empirical assessment of competency to consent to psychiatric hospitalization. American Journal of Psychiatry, 138, 1170-1176.
6. Appelbaum, P. S., Bonnie, R. J., & Karlawish, J. H. T. (2005). The capacity to vote of persons with Alzheimer's disease. American Journal of Psychiatry, 162, 2094-2100.
7. Appelbaum, P. S., & Grisso, T. (1988). Assessing patients' capacities to consent to treatment. New England Journal of Medicine, 319, 1635-1638.
8. Appelbaum, P. S., & Grisso, T. (1995). The MacArthur Treatment Competency Study 1: Mental illness and competence to consent to treatment. Law and Human Behavior, 19, 105-126.
9. Appelbaum, P. S., & Grisso, T. (2001). MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR). Sarasota, FL: Professional Resource Press.
10. Appelbaum, P. S., & Roth, L. (1981). Clinical issues in the assessment of competence. American Journal of Psychiatry, 138, 1462-1467.
11. Barton, C. D., Mallik, H. S., Orr, W. B., & Janofsky, J. S. (1996). Clinicians' judgement of capacity of nursing home patients to give informed consent. Psychiatric Services, 47, 956-960.
12. Bean, G., Nishisato, S., Rector, N. A., & Clancy, G. (1996). The assessment of competence to make a treatment decision: An empirical approach. Canadian Journal of Psychiatry, 41, 85-92.
13. Berg, J. W., Appelbaum, P. S., Lidz, C. W., & Parker, L. S. (2001). Informed consent: Legal theory and clinical practice. New York: Oxford University Press.
14. Caralis, P. V., Davis, B., Wright, K., & Marcial, E. (1993). The influence of ethnicity and race on attitudes towards advance directives, life-prolonging treatments, and euthanasia. The Journal of Clinical Ethics, 4, 155-165.
15. Carney, M. T., Neugroschl, J., Morrison, R. S., Marin, D., & Siu, A. L. (2001). The development and piloting of a capacity assessment tool. The Journal of Clinical Ethics, 12, 17-23.
16. Cramer, K., Tuokko, H., Mateer, C., & Hultsch, D. (2004). Measuring awareness of financial skills: Reliability and validity of a new measure. Aging and Mental Health, 8, 161-171.
17. Dellasega, C., Frank, L., & Smyer, M. (1996). Medical decision-making capacity in elderly hospitalized patients. Journal of Ethics, Law and Aging, 2, 65-74.
18. Drane, J. F. (1985). The many faces of competency. Hastings Center Report, 15, 17-21.
19. Dunn, L. B., & Jeste, D. V. (2001). Enhancing informed consent for research and treatment. Neuropsychopharmacology, 24, 595-607.
20. Dymek, M. P., Atchison, P., Harrell, L., & Marson, D. C. (2001). Competency to consent to medical treatment in cognitively impaired patients with Parkinson's disease. Neurology, 56, 17-24.
21. Dymek, M. P., Marson,. D. C., & Harrell, L. (1999). Factor structure of capacity to consent to medical treatment in patients with Alzheimer's disease: An exploratory study. Journal of Forensic Neuropsychology, 1, 27-48.
22. Earnst, K. S., Marson, D. C., & Harrell, L. E. (2000). Cognitive model of physicians' legal standard and personal judgments of competency in patients with Alzheimer's disease. Journal of the American Geriatric Society, 48, 919-927.
23. Eleazer, G. P., Hornung, C. A., Egbert, C. B., Egbert, J. R., Eng, C., & Hedgepeth, J., et al. (1996). The relationship between ethnicity and advance directives in a frail older population. Journal of the American Geriatrics Society, 44, 938-943.
24. Etchells, E., Darzins, P., Silberfeld, M., Singer, P. A., McKenny, J., & Naglie, G., et al. (1999). Assessment of patients' capacity to consent to treatment. Journal of General Internal Medicine, 14, 27-34.
25. Fitten, L. J., Lusky, R., & Hamann, C. (1990). Assessing treatment decision-making capacity in elderly nursing home residents. Journal of the American Geriatrics Society, 38, 1097-1104.
26. Fitten, L. J., & Waite, M. S. (1990). Impact of medical hospitalization on treatment decision making capacity in the elderly. Archives of Internal Medicine, 150, 1717-1721.
27. Frank, L., Smyer, M., Grisso, T., & Applebaum, P. (1999). Measurement of advance directive and medical treatment decision-making capacity of older adults. Journal of Mental Health and Aging, 5, 257-27'4.
28. Ganzini, L., Volicer, L., Nelson, W., & Derse, A. (2003). Pitfalls in the assessment of decision-making capacity. Psychosomatics, 44, 237-243.
29. Griffith, H., Belue, K., Sicola, A., Krzywanski, S., Zamrini, E., Harrell, L., & Marson D.C. (2003). Impaired financial abilities in mild cognitive impairment: A direct assessment approach. Neurology, 60, 449-457.
30. Grisso, T. (1986). Evaluating Competencies: Forensic Assessments and Instruments. New York, NY: Plenum Press.
31. Grisso, T. (2003). Evaluating competences, 2nd edition. New York: Plenum.
32. Grisso, T., & Appelbaum, P. S. (1995). The MacArthur Treatment Competency Study III: Abilities of patients to consent to psychiatric and medical treatment. Law and Human Behavior, 19, 149-174.
33. Grisso, T., & Appelbaum, P. S. (1998a). Assessing competence to consent to treatment. New York: Oxford University Press.
34. Grisso, T., & Appelbaum, P. S. (1998b). MacArthur Competency Assessment Tool for Treatment (MacCAT-T). Sarasota, FL: Professional Resource Press.
35. Gurrera, R. J., Moye, J., Karel, M. J., Azar, A. R., & Armesto, J. C. (2006). Cognitive performance predicts treatment decisional abilities in mild to moderate dementia. Neurology, 66, 1367-1372.
36. Havens, J. J., & Schervish, P. G. (2003). Why the $41 trillion wealth transfer estimate is still valid: A review of challenges and questions. The Journal of Gift Planning, 7, 11-15, 47-50.
37. Huthwaite, J., Martin, R., Griffith, H. R., Anderson, B., Harrell, L., & Marson, D. (in press). Declining medical decision-making capacity in mild Alzheimer's disease: A two-year longitudinal study. Behavioral Sciences and the Law.
38. Jahng, K. H., Martin, L. R., Golin, C. E., & DiMatteo, M. R. (2005). Preferences for medical collaboration: Patient-physician congruence and patient outcomes. Patient Education and Counseling, 57, 308-314.
39. Kapp, M. (1992). Geriatrics and the law: Patient rights and professional responsibilities. New York: Springer.
40. Kapp, M. B., & Mossman, D. (1996). Measuring decisional capacity: Cautions on the construction of a "capacimeter." Psychology, Public Policy, and Law, 2, 73-95.
41. Karel, M. J. (2000). The assessment of values in medical decision making. Journal of Aging Studies, 14, 403-422.
42. Karlawish, J. H. T., & Schmitt, F. A. (2000). Why physicians need to become more proficient in assessing their patients' competency and how they can achieve this. Journal of the American Geriatrics Society, 48, 1014-1016.
43. Kim, S. Y. H., Caine, E. D., Currier, G. W., Leibovici, A., & Ryan, J. M. (2001). Assessing the competence of persons with Alzheimer's disease in providing informed consent for participation in research. American Journal of Psychiatry, 158, 712-717.
44. Kim, S. Y. H., Karlawish, J. H. T., & Caine, E. D. (2002). Current state of research on decision-making competence of cognitively impaired elderly persons. American Journal of Geriatric Psychiatry, 10, 151-165.
45. Krynski, M. D., Tymchuk, A. J., & Ouslander, J. G. (1994). How informed can consent be? New light on comprehension among elderly people making decisions about enteral tube feeding. The Gerontologist, 34, 36-43.
46. Lichtenberg, P. A., & Strzepek, D. M. (1990). Assessments of institutionalized dementia Patients' competencies to participate in intimate relationships. The Gerontologist, 30, 117-120.
47. Loeb, P. (1996). Independent living scales. San Antonio: Psychological Corporation.
48. Markson, L. J., Kern, D. C., Annas, G. J., & Glantz, L. H. (1994). Physician assessment of patient competence. Journal of American Geriatrics Society, 42, 1074-1080.
49. Marson, D. C. (2001). Loss of financial competency in dementia: Conceptual and empirical approaches. Aging. Neuropsychology, and Cognition, 8, 164-181.
50. Marson, D. C., Annis, S. M., McInturff, B., Bartolucci, A., & Harrell, L. E. (1999). Error behaviors associated with loss of competency in Alzheimer's disease. Neurology, 53, 1983-1992.
51. Marson, D. C., & Briggs, S. (2001). Assessing competency in Alzheimer's disease: Treatment consent capacity and financial capacity. In S. Gauthier & J. L. Cummings (Eds.), Alzheimer's disease and related disorders annual: 2001. London: Martin Dunitz.
52. Marson, D. C., Chatterjee, A., Ingram, K. K., & Harrell, L. E. (1996). Toward a neurologic model of competency: Cognitive predictors of capacity to consent in Alzheimer's disease using three different legal standards. Neurology, 46, 666-672.
53. Marson, D. C., Cody, H. A., Ingram, K. K., & Harrell, L. E. (1995). Neuropsychological predictors of competency in Alzheimer's disease using a rational reasons legal standard. Archives of Neurology, 52, 955-959.
54. Marson, D. C., Eamst, K., Jamil, F., Bartolucci, A., & Harrell, L. E. (2000). Consistency of Physicians' legal standard and personal judgments of competency in patients with Alzheimer's disease. Journal of the American Geriatrics Society, 48, 911-918.
55. Marson, D. C., Hawkins, L., McInturff, B., & Harrell, L. E. (1997). Cognitive models that predict physician judgments of capacity to consent in mild Alzheimer's disease. Journal of the American Geriatrics Society, 45, 458-464.
56. Marson, D. C., Huthwaite, J., & Hebert, K. (2004). Testamentary capacity and undue influence in the elderly: A jurisprudent therapy perspective. Law and Psychology Review, 28, 71-96.
57. Marson, D. C., & Ingram, K. (1996). Competency to consent to research: A growing field of research. Journal of Ethics. Law, and Aging, 2, 59-63.
58. Marson, D. C., Ingram, K. K., Cody, H. A., & Harrell, L. E. (1995). Assessing the competency of patients with Alzheimer's disease under different legal standards. Archives of Neurology, 52, 949-954.
59. Marson, D. C., McInturff, B., Hawkins, L., Bartolucci, A., & Harrell, L. E. (1997). Consistency of physician judgments of capacity to consent in mild Alzheimer's disease. The American Geriatrics Society, 45, 453-457.
60. Marson, D. C., Sawrie, S., Snyder, S., McInturff, B., Stalvey, T., & Boothe, A., et al. (2000). Assessing financial capacity in patients with Alzheimer's disease: A conceptual model and prototype instrument. Archives of Neurology, 57, 877-884.
61. Meisel, A., Roth, L., & Lidz, C. W. (1977). Toward a model of the legal doctrine of informed consent. American Journal of Psychiatry, 134, 285-289.
62. Moye, J. (2000). Mr. Franks refuses surgery - cognition and values in competency determination in complex cases. Journal of Aging Studies, 14, 385-401.
63. Moye, J. (2003). Guardianship and conservatorship. In T. Grisso (Ed.), Evaluating competencies (pp. 309-390). New York: Plenum Press.
64. Moye, J., Gurrera, R. J., Karel, M. J., Edelstein, B., & O'Connell, C. (2006). Empirical advances in the assessment of the capacity to consent to medical treatment: Clinical implications and research needs. Clinical Psychology Review, 26, 1054-1077.
65. Moye, J., & Karel, M. (1999). Evaluating decisional capacities in older adults: Results of two clinical studies. Advances in Medical Psychology, 10, 71-84.
66. Moye, J., Karel, M. J., & Armesto, J. C. (2007). Evaluating capacity to consent to treatment. In A. M. Goldstein (Ed.), Forensic psychology: Emerging topics and expanding roles (pp. 260-293). Hoboken, NJ: Wiley.
67. Moye, J., Karel, M. J., Azar, A. R., & Gurrera, R. J. (2004a). Capacity to consent to treatment: Empirical comparison of three instruments in older adults with and without dementia. The Gerontologist, 44, 166-175.
68. Moye, J., Karel, M. J., Azar, A. R., & Gurrera, R. J. (2004b). Hopes and cautions for instrument- based evaluations of consent capacity: Results of a construct validity study of three instruments. Ethics, Law, and Aging Review, 10, 39-61.
69. Moye, J., Karel, M. J., Gurrera, R. J., & Azar, A. R. (2006). Neuropsychological predictors of decision-making capacity over 9 months in mild to moderate dementia. Journal of General Internal Medicine, 21, 78-83.
70. National Center on Elder Abuse. (2005). Fifteen questions and answers about elder abuse. Washington, DC: Aulhor.
71. National Conference of Commissioners on Uniform State Laws. (1993). Uniform Health Care Decisions Act. Retrieved November 10, 2006, from http://www.law.upenn.edu/bll/ulc/fnact99/1990s/uhcda93.pdf
72. Pruchno, R. A., Smyer, M. A., Rose, M. S., Hartman-Stein, P. E., & Laribee-Henderson, D. L. (1995). Competence of long-term care residents to participate in decisions about their medical care: A brief, objective assessment. The Gerontologist, 35, 622-629.
73. Roth, L. H., Meisel, C. A., & Lidz, C. A. (1977). Tests of competency to consent to treatment. Canadian Journal of Psychiatry, 134, 279-284.
74. Royall, D. R., Cordes, J., & Polk, M. (1997). Executive control and the comprehension of medical information by elderly retirees. Experimental Aging Research, 23, 301-313.
75. Rutman, D., & Silberfeld, M. (1992). A preliminary report on the discrepancy between clinical and test evaluations of competency. Canadian Journal of Psychiatry, 37, 634-639.
76. Sabatino, C. (1996). Competency: Refining our legal fictions. In M. Smyer, K. W. Schaie, & M. B. Kapp (Eds.), Older adults' decision making and the law (pp. 1-28). New York: Springer.
77. Saks, E. R., Dunn, L. B., Marshall, B. J., Nayak, G. V., Golshan, S., & Jeste, D. V. (2002). The California Scale of Appreciation: A new instrument to measure the appreciation component of capacity to consent to research. American Journal of Geriatric Psychiatry, 10, 166-174.
78. Schmand, B., Gouwenberg, B., Smit, J. H., & Jonker, C. (1999). Assessment of mental competency in community-dwelling elderly. Alzheimer Disease and Associated Disorders, 13, 80-87.
79. Smyer, M. A., Schaie, K. W., & Kapp, M. B. (1996). Older adults' decision-making and the law. New York: Springer.
80. Staats, N., & Edelstein, B. (1995). Cognitive changes associated with the declining competency of older adults. Paper presented at the annual meeting of the Gerontological Society of America, Los Angeles, CA.
81. Staats, N., Edelstein, B., & Null, J. (1995). Neuropsychological correlates of thinking rationally about treatment tests. Paper presented at the annual meeting of the Gerontological Society of America, Los Angeles, CA.
82. Stanley, B., Stanley, M., Guido, J., & Garvin, L. (1988). The functional competency of elderly at risk. The Gerontologist, 28(Suppl. June 1988), 53-58.
83. Sturman, E. D. (2005). The capacity to consent to treatment and research: A review of standardized assessment tools. Clinical Psychology Review, 25, 954-974.
84. Taub, H. A., Baker, M. T., Kline, G. E., & Sturr, J. F. (1987). Comprehension of informed consent by young-old and old-old volunteers. Experimental Aging Research, 13, 173-178.
85. Tepper, A., & Elwork, A. (1984). Competency to consent to treatment as a psycho-legal construct. Law and Human Behavior, 8, 205-223.
86. Tuokko, H., Morris, C. & Ebert, P. (2005). Mild cognitive impairment and everyday functioning in older adults. Neurocase, 11, 40-47.
87. Tymchuk, A. J., Ouslander, J. G., & Fitten, J. (1988). Medical decision-making among elderly people in long term care. The Gerontologist, 28, 59-637
88. Van Wielingen, L., Tuokko, H., Carmer, K., Mateer, C. & Hultsch, D. (2004). Awareness of financial skills in dementia. Aging and Mental Health, 8, 374-380.
89. Wolinsky, F., & Johnson, R. (1991). The use of health services by older adults. Journal of Gerontology: Social Sciences, 46, S345-S357.
90. Wong, J. G., Cheung, E. P., & Chen, E. Y. (2005). Decision-making capacity of inpatients with schizophrenia in Hong Kong. Journal of Nervous and Mental Disease, 193, 316-322.
91. Wong, J. G., Clare, I. C. H., Holland, A. J., Watson, P. C. & Gunn, M. (2000). The capacity of people with a "mental disability" to make a health care decision. Psychological Medicine, 30, 295-306.