Assessment of Older Adults with

1 Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists American Bar Association Commission on Law and aging American Psychological Association 1 Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists American Bar Association/American Psychological Association Assessment of Capacity in Older Adults Project Working Group Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists American Bar Association Commission on Law and aging American Psychological Association 2 About the American Bar Association Commission on Law and aging The mission of the American Bar Association (ABA) Commission on Law and aging is to strengthen and secure the legal rights, dignity, autonomy, quality of life, and quality of care of elders.

2 It carries out this mission through research, policy development, technical assistance, advocacy, education, and training. The ABA Commission consists of a 15-member interdisciplinary body of experts in aging and law, including lawyers, judges, health and social services professionals, academics, and advocates. With its professional staff, the ABA Commission examines a wide range of law-related issues, including: legal services to Older persons; health and long-term care; housing needs; professional ethical issues; Social Security, Medicare, Medicaid, and other public benefit programs; planning for incapacity; guardianship; elder abuse; health care decision-making; pain management and end-of-life care; dispute resolution.

3 And court-related needs of Older persons with disabilities. About the American Psychological Association The American Psychological Association (APA) is the largest scientific and professional organization representing psychology in the United States and is the world s largest association of psychologists. Through its divisions in 53 subfields of psychology and affiliations with 59 state, territorial, and Canadian provincial associations, APA works to advance psychology as a science, as a profession, and as a means of promoting health, education, and human welfare.

4 The APA Office on aging coordinates the association s activities pertaining to aging and geropsychology (the field within psychology devoted to Older adult issues). The Committee on aging (CONA) is the committee within the APA governance structure dedicated to aging issues. Its six expert geropsychologists are selected for three-year terms. Together, the Office on aging , CONA, and association members promote the health and wellbeing of Older Adults and their families through expanded scientific understanding of adult development and aging and the delivery of appropriate psychological services to Older Adults .

5 Disclaimer The views expressed in this document have not been approved by the governing or policy-setting bodies of the American Bar Association or the American Psychological Association and should not be construed as representing policy of these organizations. Materials in this book were developed based on the consensus of a working group. This document is not intended to establish a standard of practice against which clinical practice is to be evaluated.

6 Rather, it provides a framework that psychologists may find useful and effective in capacity determination. Although the principles presented herein are intended to be generally relevant across all legal jurisdictions, law and practice differ across state jurisdictions and sometimes even across county lines. Thus, this book is intended to supplement (and cannot substitute for) a psychologist s working knowledge of relevant capacity law specific to his/her jurisdiction.

7 This book focuses on issues in civil capacity determination in Older Adults , not all aspects of capacity evaluation or all populations. Copyright (c) 2008 by the American Bar Association and the American Psychological Association. All rights reserved. No permission is needed to reproduce the Capacity Worksheet for Psychologists, in print or electronic form, for classroom use in an institution of higher learning, or for use in clinical practice, provided that the use is for noncommercial purposes only and acknowledges original publication by the ABA and the APA.

8 For permission to reproduce any other content from this Handbook, or for commercial use of the Worksheet, please request permission from the American Psychological Association at 10 Digit ISBN Number: 1-60442-234-3 13 Digit ISBN Number: 978-1-60442-234-4 ABA Product Code: 4280029 Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists American Bar Association Commission on Law and aging American Psychological Association 3 Table of Contents Acknowledgements.

9 5 Executive Summary .. 6 I. The Importance of Psychological Assessment of Capacities .. 8 II. Legal Standards of Diminished Capacity .. 15 III. Conceptual Framework for Capacity Assessment .. 23 IV. Investigating the Referral and Planning Your Approach .. 29 V. General Approaches to Assessing the Older Adult .. 37 Capacity Worksheet for Psychologists .. 47 VI. Assessing Specific 51 Medical Consent .. 51 Functional 52 Sexual Consent Capacity .. 62 Financial Capacity .. 71 Testamentary 81 Driving Capacity.

10 91 Independent Living .. 101 VII. Undue Influence .. 113 VIII. Working with Lawyers and Courts .. 121 IX. Emerging Issues .. 131 X. References .. 136 Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists American Bar Association Commission on Law and aging American Psychological Association 4 Appendices Available online at Appendix A. Glossary .. 148 Appendix A. Glossary .. 149 Appendix B. Functional Assessment .. 156 Appendix C. Cognitive Assessment .