Assessing capacity in the setting of self-neglect: development of a novel screening tool for decision-making capacity.
Compared with older adults with disabilities and those who autonomously choose to live in squalor, self-neglect syndrome arises from a predicate state of vulnerability in frail older adults. This state of vulnerability is characteristically associated with a decline in decision-making capacity regarding the ability to care for and protect oneself. We developed the COMP Screen to evaluate vulnerable older adults to identify potential gaps in decision-making capacity using a screening tool. A total of 182 older adults were evaluated and consistent declines in cognitive ability and decision-making processes were present in this population. However, there were no significant differences between elders referred for self-neglect and matched older adults. These findings suggest that declines in decision-making processes are not uncommon in vulnerable older adults but traditional conceptualizations of decision-making capacity may be inadequate for differentiating the capacity for self-care and protection in elders who self-neglect.
Naik
Aanand D
AD
Baylor College of Medicine, USA. anaik@bcm.tmc.edu
Pickens
Sabrina
S
Burnett
Jason
J
Lai
James M
JM
Dyer
Carmel Bitondo
CB
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003657:Decision Making / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016743:Mental Competency / Q000523:psychology*; D010865:Pilot Projects; D012189:Retrospective Studies; D012648:Self Care / Q000523:psychology*; D013781:Texas