St. Mark’s Adult Education Meeting Summary
“The Psychological and Legal Factors Related to
Loss of Competency for Independent Living by Older Adults.”
Discussion Led By Bill Askren
Sunday, January 23, 2005
Assessing The Independence Competency Of Older Adults
William B. Askren, PhD, Psychology
SUMMARY
The ability to influence one’s own life, such as making independent decisions about living situations, about finances, and about medical care options is central to a sense of self-control. This is critical, also, to family members who must lovingly relate to the older adult. The legal and psychological factors related to determining when a person loses independent decision making ability are discussed.
OUTLINE
– Legal Issues
– Psychological Assessment
– Practical Markers/Symptoms Of Loss Of Competency
LEGAL ISSUES
– Balancing Values
– Rights Of Individual
– Rights Of Society
– Balancing A Court Judgment
– General Principles Across States (Grisso, 1986)
. Functional Deficits
* Cannot comprehend information needed for decision making
* Lacks reality base of information
* Lacks problem solving skill
. Causes Of Deficits
. Consequences Of Decisions And Actions
– Ohio Revised Code
Ohio Revised Code
Guardians; Conservatorships, 2111.01, Note 3
“Incompetent” means any person who is so mentally impaired as a result of a mental or physical illness or disability, or mental retardation, or as a result of chronic substance abuse, that the person is incapable of taking proper care of the person’s self or property or fails to provide for the person’s family or other persons for whom the person is charged by law to provide, or any person confined to a correctional institution within this state.
PSYCHOLOGICAL ASSESSMENT PROCEDURES
– Referral Clarification
– Assessment
. Interviews with patient, family, health care providers
. Testing of cognitive functioning
* Attention & Concentration
* Short Term Working Memory
* Reasoning And Problem Solving
* Language
* Visuospatial
. Evaluation of mental health status
* Thinking Disturbance
* Withdrawal/Retardation
* Hostility/Suspiciousness
* Anxiety/Depression
. Evaluation of activities of daily living
– Synthesis Of Data, Conclusions, Communication Of Findings
– Follow-Up
PRACTICAL SYMPTOMS OF LOSS OF COMPETENCY
– Medication
– Meal Preparation & Eating
– Toileting
– Body Hygiene
– Mobility/Self Transfer
– Dressing
– Money Management
– Telephone Use
– Driving/Using Transport
– Laundry
– House Care/Cleaning – Shopping
