Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention

JAMA ◽  
2009 ◽  
Vol 301 (7) ◽  
pp. 776
Author(s):  
Leslie K. Ross
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Decision Making Capacity

scholarly journals The Decision-Making and Communication Capacities of Older Adults with Dementia: A Population-Based Study

2014 ◽  
Vol 8 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Kazuko Mitoku ◽  
Setsu Shimanouchi
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Long Term Care ◽  
Population Based ◽  
Term Care ◽  
Daily Lives ◽  
People With Dementia ◽  
Decision Making Capacity ◽  
One Year

The present study assessed the decision-making and communication capacities of older adults with dementia who required assistance and care and measured the subsequent changes in these capacities. Of 845 older adults who received long-term care between April 2003 and December 2004, about half of them without dementia were excluded and the remaining 448 were finally included in the analyses. These individuals were completed follow-up for assessment for two years. The data were obtained from the Long-Term Care Insurance Certification Committee for Eligibility in Gujo City. A total of 73.7% of people with dementia were somewhat capable of making decisions (32.4% were reported as being “always capable”; 41.3% were reported as being “sometimes capable”). A total of 93.7% were somewhat capable of communicating with others (78.3% were reported as being “always capable”; 15.4% were reported as being “sometimes capable”). The results indicate that older adults with dementia can participate in their own care decisions, even if they require assistance and support in their daily lives. The present study shows, however, that baseline decision-making capacity declined to about half what they were after one year and to about one-third of what they were after two years, suggesting that earlier efforts are needed to ensure that the preferences of individuals with dementia are reflected in their care.

scholarly journals 27 Decision-Making Capacity Assessment: Occupational Therapy’s Contribution within a Multidisciplinary Approach

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Ruth Usher ◽  
Tadhg Stapleton
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Financial Management ◽  
Independent Living ◽  
Online Survey ◽  
Occupational Therapists ◽  
Further Education ◽  
Capacity Assessment ◽  
Decision Making Capacity ◽  
Health And Social Care

Abstract Background Increasing age and life expectancy, alongside the growing incidence of chronic conditions and dementia-related diseases, indicate more older individuals are likely to experience challenges regarding decision-making capacity. In Ireland, the Assisted Decision Making (Capacity) Act 2015 provides a statuary framework for adults who are experiencing difficulties with decision-making. This legislation has significant implications for all who work in health and social care, especially those working with older adults. An online survey was conducted to explore occupational therapy practices regarding decision-making capacity assessment and factors impacting on engagement in this area. Methods Occupational therapists in Ireland were invited to participate in a cross-sectional online questionnaire. Results One hundred and seventy-two occupational therapists responded. Most occupational therapists (65.77%, n=98) reported involvement in decision-making capacity assessments, particularly those working with older adults. Occupational therapists were more frequently requested to contribute to assessments of capacity regarding independent living (79.19%, n=118), driving (45.89%, n=67), and financial management (44.44%, n=64). Occupational therapists reported using a combination of approaches to inform decision-making capacity assessment, including interviews, observations and assessments of cognition and functional performance, and emphasised a strength-based approach. Many participants reported decision-making capacity assessment is more difficult than other aspects of practice and that they are not satisfied with decision-making capacity assessment procedures in their workplace. A large majority (91.86%, n=113) reported occupational therapists would benefit from additional training and practice resources for decision-making capacity assessment. Conclusion The study confirms that occupational therapists have a role to play in assessment of decision-making capacity assessment, particularly regarding independent living. However, the recommended approach to assessment should include all appropriate multidisciplinary team members. There is need for further education, resources and guidelines for occupational therapists and other healthcare professionals to better guide decision-making capacity assessment.

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