Leslie Kernisan
(2024, November 30). Better Health While Aging.
Perhaps your elderly father insists he has no difficulties driving, even though he’s gotten into some fender benders and you find yourself a bit uncomfortable when you ride in the car with him.
Or you’ve worried about your aging aunt giving an alarming amount of money to people who call her on the phone.
Or maybe it’s your older spouse, who has started refusing to take his medication, claiming that it’s poisoned because the neighbor is out to get him.
These situations are certainly concerning, and they often prompt families to ask me if they should be worried about an older adult becoming “incompetent.”
In response, I usually answer that we need to do at least two things:
- We should assess whether the person has “capacity” to make the decision in question.
- If there are signs concerning for memory or thinking problems, we should evaluate to determine what might be causing them.
If you’ve been concerned about an older person’s mental wellbeing or ability to make decisions, understanding what clinicians — and lawyers —mean by capacity is hugely important.
The website addresses concerns related to the decision-making capacity of older adults, particularly in light of cognitive impairments such as dementia. It emphasizes the importance of understanding "capacity," which refers to an individual's ability to make informed decisions about specific matters. Dr. Leslie Kernisan outlines that capacity is not a binary state; instead, it is decision-specific and can fluctuate based on health conditions. For example, an older adult may retain the capacity to make simple decisions but struggle with more complex ones, especially if they are experiencing health issues or cognitive decline.
Dr. Kernisan distinguishes between incapacity and incompetence, noting that capacity is typically assessed in clinical settings by healthcare professionals, while competence is a legal determination made by courts. The document explains that various types of decisions—such as medical consent, financial matters, and driving—require different capacities, and the legal standards for these capacities can vary by state.
The article also highlights the impact of Alzheimer's disease and other dementias on decision-making abilities. In early stages, individuals may still have the capacity for many decisions, but as the disease progresses, their ability to make even simple choices may diminish. Therefore, it is crucial for families to seek clinical assessments of capacity when there are concerns about an older adult's decision-making abilities.
Moreover, the document advises that legal determinations of incapacity may be necessary before overriding an older person's decisions, especially in matters concerning safety or financial well-being. Families are encouraged to consult with legal professionals when navigating these issues to ensure they are acting within legal and ethical boundaries.
Overall, the article serves as a practical guide for caregivers and family members dealing with the complexities of aging and cognitive decline, stressing the need for respectful communication and proactive measures to protect the autonomy and safety of older adults.
