Incompetence & Losing Decision Capacity in Aging Adults: FAQs
Caregivers should determine whether an older adult has the “capacity” to make a decision, and it is critical to understand what clinicians and lawyers mean by capacity. “Understand Decisional Capacity,” according to the American Bar Association’s Ten Legal Tips for Caregivers, is tip #1.
What does the term “capacity” mean when it comes to decision-making?
When we ask if a person has the capacity to make a decision, we’re asking if they can demonstrate that they have the mental abilities required to make the decision. Different types of decisions require different types of mental abilities, and state law sets the legal standards for capacity. When a person is feeling good and at their best, their mental abilities may be sufficient.
What is the difference between incapacity and incompetence?
States are moving away from global legal determinations that a person is “incompetent,” and instead referring to “legal capacity” rather than “clinical capacity” is more accurate.
How is capacity determined?
In most cases, we assume that adults have capacity; however, if others raise concerns about capacity, a process of assessing capacity may be initiated. Legal professionals are not trained to clinically assess capacity; such assessments must be performed by professionals with a healthcare background.
Does capacity have to be determined by legal professionals? Is it a “legal decision” whether someone has capacity?
Physicians and other clinicians are allowed to determine capacity for medical decisions in most states; however, many people act without fully understanding the laws and procedures surrounding capacity, so if a family suspects loss of capacity, it’s best to seek legal advice first.
Do I have to have a legal or clinical determination of incapacity for a specific decision, before I override the decision of an older person with dementia?
Yes, if you are concerned about a dementia such as Alzheimer’s disease, you should seek a clinical assessment of capacity, especially if you believe the disease has progressed to the point where a person has lost the ability to make certain decisions. Even if you have obtained a legal determination of incapacity for certain decisions, it’s critical to act in accordance with ethical best practices.
Do I need a legal or clinical determination of incapacity before I take the car keys away from an older parent who has dementia and is an unsafe driver?
You can also try to persuade others in the older person’s social circle to give up the keys by obtaining a legal determination of incapacity to drive. Some states require clinicians to report moderate or severe dementia to the DMV. You can also try to persuade others in the older person’s social circle to give up the keys by obtaining a legal determination of incapacity to drive.
Is neuropsychological testing required to assess capacity?
Neuropsychological tests can also be used if a preliminary clinical evaluation yields borderline or uncertain results, and can help determine if a person has mild, subtle, or focused cognitive impairments.
Resources & References to Help You Understand Capacity
This article is based on my review of the above resources, as well as my own clinical experiences and conversations with attorneys and other experts. I am not an attorney or a psychologist, but I do have some expertise in the area of mental health.
What to do when elderly parents make bad decisions?
When Elderly Parents Refuse to Help: 8 Communication Strategies
- Accept the situation.
- Choose your battles.
- Don’t be too hard on yourself.
- Treat your aging parents like adults.
- Ask them to do it for the kids (or grandkids)
- Find an outlet for your feelings.
- Include them in future plans.
Why do older people have trouble making decisions?
Because of this decline in overall computational power, as well as the corresponding decline in important cognitive faculties such as attention and memory, older adults frequently make irrational decisions, particularly in response to financial tasks, even though other cognitive skills may actually improve with experience.
How do you communicate with difficult elderly and older adults?
How to Talk to Difficult Seniors and Elderly People
- Ask Instead of Ordering.
- Ask Instead of Assuming.
- Use “I” instead of “You” Language.
- Offer Choices Whenever Possible.
- Set Consequences.
How do you deal with a manipulative elderly parent?
However, if there is an underlying cause that can be addressed, their behavior and your relationship with them may be improved.
- Take Care of Yourself.
- Take a Step Back.
- Provide Them With Personal Power.
- Make Internal Adjustments.
- Set Boundaries For Elderly Parents.
- Take Care of Yourself.
How can you tell if an elderly person is competent?
Individuals must be able to do the following in order to be considered competent:
- Comprehend information presented to them.
- Recognize the significance of such information.
- Make sound decisions from a variety of options.
- Recognize the potential consequences of their decisions.
How do you set boundaries with elderly difficult parents?
Setting Limits With Difficult Aging Parents
- Before you go, make a plan.
- Set ground rules and stick to them.
- When trying to have a sincere and meaningful conversation with your parent, use a non-threatening approach.
- Try to understand why your parent is hostile or abusive.
- Remember, you are an adult.
How do older adults make decisions?
Our research suggests that older adults’ better emotion regulation may well contribute to their ability to make better decisions and resist the “sunk cost bias” when confronted with adversity, whereas younger adults tend to ruminate on the negative.
Does old age affect decision-making?
We gain life experiences and knowledge that guide our decision-making as we get older, and the combination of gains and losses can lead to older people using different decision-making strategies, as well as neural adaptations that help older adults compensate for memory declines.
Do adults have better Judgement?
However, research has shown that younger adults make better decisions than older adults. We make decisions all of our lives, so you’d think we’d get better at it over time. However, research has shown that younger adults make better decisions than older adults.
How do you communicate effectively with elderly?
A list of suggestions is provided below to assist you in achieving this goal.
- Allow extra time for older patients.
- Avoid distractions.
- Sit face to face.
- Make eye contact.
- Speak slowly, clearly, and loudly.
- Use short, simple words and sentences.
What do seniors like to be called?
Seniors (but not senior citizens), retirees, older people, and older adults are some of the most popular terms for the elderly. Pensioners is acceptable, and elders is embraced by those who see it as a sign of respect.
What is the leading cause of death for older adults?
Chronic diseases such as heart disease, cancer, stroke, diabetes, and Alzheimer’s disease account for roughly three-quarters of all deaths in people aged 65 and up, with chronic diseases such as heart disease, cancer, stroke, diabetes, and Alzheimer’s disease replacing acute infections as the leading causes of death during the twentieth century.
Are you legally responsible for your elderly parents?
In the United States, requiring children to care for their elderly parents is a state-by-state issue, with some states requiring no such obligation. Currently, 27 states have filial responsibility laws, but children in Wisconsin are not legally liable for their elderly parents’ care.
How do you deal with a difficult elderly mother?
With this in mind, here are some suggestions for dealing more effectively with a difficult elderly parent.
- Be sensitive.
- Talk about your concerns without putting pressure on your parent.
- Work together to find compromises.
- Accept their decision.
- Pick your battles.
- Choose your timing.
What stage of dementia is anger?
Aggressive Behavior by Dementia Stage Anger and aggression are most likely to appear as symptoms in the middle stages of dementia, along with other concerning habits such as wandering, hoarding, and unusual compulsive behaviors.