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Assessing the Capacity to Make Everyday Decisions: A Guide for Clinicians and an Agenda for Future Research

From the Department of Medicine, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT (JL); and the Department of Medicine, Division of Geriatrics, Leonard Davis Institute of Health Economics, Center for Bioethics, Center for Clinical Epidemiology and Biostatistics, Alzheimer’s Disease Center, and Institute on Aging, at the University of Pennsylvania, Philadelphia, PA (JK).

Assessing the capacity of patients to make decisions about their functional problems has substantial ethical, clinical, and financial implications. The growing population of older adults with cognitive impairment either in the community or in long-term care and medical facilities increase the importance of adequately assessing this capacity. This review examines the current approaches to making this assessment, demonstrates how they are incomplete, and considers potential approaches for improving these evaluations. Future research should develop and validate methods to identify patients with impaired capacity to make everyday decisions. These data will supplement functional, cognitive, and medical assessments.

Key Words: Capacity • cognitive impairment • decision-making • dementia • activities of daily living

This article has been cited by other articles:

				J. M. Lai, T. M. Gill, L. M. Cooney, E. H. Bradley, K. A. Hawkins, and J. H. Karlawish Everyday Decision-Making Ability in Older Persons With Cognitive Impairment Am J Geriatr Psychiatry, August 1, 2008; 16(8): 693 - 696. [Abstract] [Full Text] [PDF]

				C. F. Reynolds III Assessing the Capacity to Make Everyday Decisions About Functional Problems: Where Does the Field Go From Here? Am J Geriatr Psychiatry, February 1, 2007; 15(2): 89 - 91. [Full Text] [PDF]