Financial and testamentary capacity evaluations: procedures and assessment instruments underneath a functional approach

Sousa, Liliana B.; Simões, Mário R.; Firmino, Horácio; Peisah, Carmelle

doi:10.1017/s1041610213001828

Cited by 35 publications

(49 citation statements)

References 55 publications

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“…Os dados indicam uma preservação da capacidade de decidir o que deseja comer e da capacidade para gerir seu próprio dinheiro, mas não as contas da casa. Souza et al [19] investigaram instrumentos capazes de verificar a alteração em consentir financeiramente, concluindo pela necessidade do profissional da saúde em estar apto para a avaliação mais ampla do estado de saúde do paciente e incluindo as questões financeiras, permitindo uma melhor interpretação do diagnóstico, em especial ao que condiz com as questões legais. Os demais domínios mostram as alterações que ocorrem na depressão maior, enfatizando a importância da utilização de instrumentos capazes de auxiliar o diagnóstico mais preciso da perda da capacidade de decisão e da área específica em que a mesma ocorreu.…”

Section: Discussionunclassified

Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior

Crippa¹,

Gomes

Terra

2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACT AIMS: To verify if there are changes in the decision-making capacity of elderly patients with major depression. METHODS: This is a prospective cohort study with an initial cross-sectional analysis conducted between January 2014 and September 2015. Treatment-naïve elderly patients from the Cerebral Aging Outpatient Clinic at PUCRS São Lucas Hospital, in Porto Alegre, Brazil, all diagnosed with major depressive disorder, were selected. The control group was composed of elderly individuals from the same community who had neither depression nor cognitive problems. For evaluation of the decision-making capacity, the Assessment Scale for Decision-Making Capacity was designed and validated in a previous stage of the research. This instrument is divided into four domains: daily activity, financial management, self-management, and well-being. The Geriatric Depression Scale (short version) and the Mini-International Neuropsychiatric Interview (detailed version) were used to evaluate the presence of depression. The Vellore Screening Instrument for Dementia and the Addenbrooke's Cognitive Examination (revised version) were applied to evaluate cognitive decline. Decision-making capacity was compared between the two groups of elderly individuals. The same evaluation was conducted with elderly patients with depression after six months of psychiatric treatment. The statistical analysis included Student's t, Pearson's chi-square, Mann-Whitney, and Wilcoxon tests. Statistical significance was set at p≤0.05. RESULTS: Forty-eight elderly patients with major depression and 144 elderly individuals from the control group participated in the study. The Assessment Scale for Decision-Making Capacity average score in depression patients was 70.5±17.9, compared to 94.6±9.6 (p<0.001) in the control group, which indicates poorer decision-making capacity among patients with major depression. The domains with the most striking differences in the average scores were self-management (depression patients 65.0±23.3 and control group 97.8±6.2) and well-being (depression patients 52.2±27.1 and control group 91.8±16.7). When comparing patients with depression before and after treatment, regarding both the general score and the four domains of the Assessment Scale for Decision-Making Capacity, the decision-making capacity was higher after the treatment. CONCLUSIONS: The group of elderly patients with current major depression had a lower decision-making capacity compared to the control group. Their decision-making capacity improved after six months of psychiatric treatment.

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Section: Discussionunclassified

Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior

Crippa¹,

Gomes

Terra

2017

Sci Med

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“…A semi-structured interview process or CAI may provide a specific and direct answer to medico-legal questions. ( 17 , 18 )…”

Section: Methodsmentioning

confidence: 99%

A Case for the Standardized Assessment of Testamentary Capacity

et al. 2018

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BackgroundWith an increasingly aged, frail population that holds a disproportionate amount of wealth, clinicians (especially those with expertise in older adults) may be asked with more frequency to offer a clinical opinion on testamentary capacity (TC), the mental capacity to make a will.MethodThis paper reviews the legal criteria as well as the empirical research on assessment tools for determining testamentary capacity (TC). We also review the relevance of instruments used for the assessment of other decisional capacities in order to evince the potential value of developing a standardized assessment of TC for clinician experts.ResultsThe legal criteria, often referred to as a “test”, for determining requisite TC (Banks v. Goodfellow) have remained much the same since 1870 with minimal clinical input and, as such, there has been little development in TC assessment instruments. Decisional instruments designed to assess Consent to Treatment may have relevance for TC.ConclusionWe make the case for a semi-structured interview that includes standardized criteria for the legal test for TC, supplemented by a validated brief neuropsychological assessment, which together comprise a Contemporaneous Assessment Instrument (CAI) for TC.

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“…Generally speaking, when considering capacity for sexual activity, one might consider the person's understanding of sexual activity, the identity of the other and the nature and consequences of the relationship if any (e.g., anxiety, genital trauma/ itch, etc.). Importantly, with people in residential care facilities, rather than polarizing participants into victims and perpetrators, we should consider the capacity of both parties (Peisah et al 2014).…”

Section: Capacity and Relationshipsmentioning

confidence: 99%

“…Over the last 30 years, a plethora of instruments or methodologies to assess financial capacity have been developed. Sousa et al (2014) have categorized these instruments into: i. Neuropsychological assessment ii. Functional assessment scales, mostly self-report, which assess a range of activities of daily living including capacity to manage financial affairs iii.…”

Section: Capacity and Powers Of Attorneymentioning

confidence: 99%

“…Guides for performing contemporaneous (Peisah 2005;Shulman et al 2007Shulman et al , 2009Frost et al 2015) and retrospective assessments of testamentary capacity (Shulman et al 2005(Shulman et al , 2007Peisah 2005;Frost et al 2015) have been developed. The issues of deathbed wills (Peisah et al 2014), testamentary capacity and delirium (Liptzin et al 2010), and wills and suicide notes (Sinyor et al 2015) have been addressed. In addition to considering whether a testator had, or did not have testamentary capacity, the clinician must also screen for risk factors for "undue influence" (Peisah et al 2009b).…”

Section: Free Of a Mental Disorder Including Delusions That Influenmentioning

confidence: 99%

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Capacity Assessment

Peisah¹

2016

Mental Health and Illness Worldwide

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Capacity is the ability to make decisions. Autonomy in decision-making and being safeguarded against abuse and undue influence are fundamental human rights. This chapter will demonstrate how "good" capacity assessment can support these human rights. The assessment of capacity is a complex and highly specialized task, governed by principles of the presumption of capacity, that capacity is not diagnosis bound, and the need for individualized, task-, and situation-specific assessments. The clinician engaged to undertake a capacity assessment has a responsibility to act as gatekeeper, and sometimes advocate, for the actualization of human rights. Capacity assessment presents opportunities to identify strengths and weaknesses to inform and enable supported decisionmaking. It also provides opportunities and obligations to identify abuse. When people with disability such as mental illness are empowered to make the decisions they are capable of making, while protected from making the decisions they are incapable of making, human rights are supported. Such principles are universal, regardless of the jurisdictional variations in the laws that govern capacity and competency determinations internationally.

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Financial and testamentary capacity evaluations: procedures and assessment instruments underneath a functional approach

Cited by 35 publications

References 55 publications

Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior

Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior

A Case for the Standardized Assessment of Testamentary Capacity

Capacity Assessment

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