Decision Capacity Assessment: What’s Involved When Senior Cognition Declines

It’s no secret that growing older involves a certain amount of physical deterioration. But what many people don’t realize is that mental deterioration can come on just as quickly – and be just as dangerous. There are serious consequences when a senior lacks the ability to make wise and healthy choices about their life. They can inadvertently put their safety, well-being, and finances at risk. Needless to say, this isn’t something you want to see happen to your loved one. That’s why if you’re concerned, you may want to consider a decision capacity assessment.

What is a decision capacity assessment?

A decision capacity assessment is a determination by a medical provider about your loved one’s ability to make rational choices. It is most often completed by a primary care physician, although psychiatrists have been known to conduct them as well. It usually consists of a series of questions or exercises that the physician performs during an interview, or using a formal capacity assessment tool.
Sometimes the physician will order additional tests, depending upon the circumstances. The doctor may ask for more information from other members of the senior’s health care team, such as psychotherapists, physical therapists, visiting nurses, and more. They may even want to conduct labs or neuroimaging. But the majority of the time, assessments are no more than lengthy conversations between doctors and patients.

Why might your senior need a decision capacity assessment?

A decision capacity assessment might be needed if your senior shows a slow decline in cognition or an abrupt change in the same. For instance, if you notice them becoming much more forgetful or confused than usual, or if they suddenly start exhibiting erratic and irrational behavior, it may be time for professional intervention. Some of these changes can have physical causes (i.e., infection, a new medication, etc.) and may only be temporary. The senior’s doctor will probably want to rule out these causes in order to better determine your loved one’s decision-making abilities in the long-term.

The possible outcomes of a decision capacity assessment

Many seniors and their families fear the possible outcomes of a decision capacity assessment. However, although the results may be difficult to hear and the next steps challenging, they may not be as devastating as you think. Most families who take their seniors for such tests know that something has been wrong for a while, and it’s usually a relief to finally find out what it is and start coping.
It may also be heartening to know that just because a physician finds a senior lacking in one area of decision-making ability doesn’t mean they lack that capacity in all areas. It’s possible for a person to completely understand the ramifications of certain medical treatments, for instance, but be unable to comprehend financial aspects of their lives.
And a doctor’s opinion on the matter doesn’t mean the senior will have his or her legal rights taken away. Legal competency can only be decided by a judge, and the doctor’s assessment is just one part of what goes into rendering a judgment.
So although the physician will likely have his or her own recommendations, it’s up to you (or your senior, if they are found to have decision-making capabilities) to decide what to do. Bear in mind that often, the consequences of delaying such an assessment are far worse than the actual outcome of the test.

Get a decision capacity assessment as soon as possible

There is rarely any benefit to waiting to get a decision capacity assessment. In fact, the longer you wait, the more likely your loved one will make a decision that could permanently – and negatively – affect their entire future. It’s never easy to admit your senior needs help, either for them or for you. However, the sooner you get help in the form of a medical opinion, the sooner you can determine the best course of action for your loved one moving forward.
If you are unsure of how to best help an aging loved one, the trained and compassionate staff at the Institute on Aging is here to help you make that decision and gain the best in at-home senior care. Contact us to find out more.

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