title: Competence and the elderly patient with cognitive impairments.
abstract: OBJECTIVE
  The purpose of this paper is to discuss the assessment of competence in the elderly, focusing particularly on individuals with cognitive impairments.
  
  
  METHODS
  An analysis of autonomy forms the basis of an ethical discussion which attempts to modify the existing concept of competence.
  
  
  CONCLUSIONS
  A discussion of the factors which influence competence is presented including variations in situation, task and degree of risk. A critical analysis of four standards of competence is presented, leading to a discussion of the standards which can most successfully promote self-determination in elderly patients. Finally, three classes of competence are suggested which extend the criteria of competence to patients to cognitive deficits.
authors.affiliation: Department of Psychiatry, Royal Brisbane Hospital, Brisbane, Queensland, Australia.
authors.forename: S P
authors.initials: SP
authors.lastname: Ryan
mesh_terms: D000368:Aged; D003072:Cognition Disorders; D006801:Humans; D013647:Task Performance and Analysis