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Unformatted text preview: The Gerontologist Copyright 2007 by The Gerontological Society of America Vol. 47, No. 5, 591603 A Conceptual Model and Assessment Template for Capacity Evaluation in Adult Guardianship Jennifer Moye, PhD, 1 Steven W. Butz, PsyD, 1 Daniel C. Marson, JD, PhD, 2 Erica Wood, JD, 3 and the ABAAPA Capacity Assessment of Older Adults Working Group 3 Purpose: We develop a conceptual model and asso- ciated assessment template that is usable across state jurisdictions for evaluating the independent-living capacity of older adults in guardianship proceed- ings. Design and Methods: We used an iterative process in which legal provisions for guardianship and prevailing clinical practices for capacity assessment were integrated, through expert group consensus and external review by legal and health care professionals, to form a conceptual model and template. Results: The model and template provide a structure for conducting and documenting a capacity evaluation in guardian- ship by using six assessment domains of interest to the courts: (a) medical condition, (b) cognition, (c) func- tional abilities, (d) values, (e) risk of harm and level of supervision needed, and (f) means to enhance capacity. The template also addresses the participation of the person in the guardianship hearing, confidentiality and privilege issues, and certification by the examiner. An on- line version of the template can be adapted to address specific jurisdictional requirements. Implications: A conceptual model and evaluation template provide a useful cross-jurisdictional format for conducting and documenting capacity assessments of older adults in guardianship proceedings. The template may be par- ticularly useful to clinicians for providing courts with information to support limited guardianship orders. Key Words: Capacity, Competency, Dementia, Guardianship As our population ages, increasing numbers of older adults will experience functional loss associated with neurocognitive and neuropsychiatric diseases (Quinn, 2004). In some cases these individuals will become subject to guardianship proceedings, in which a judge may appoint a guardian to make decisions on behalf of a person determined to lack the capacity to make those decisions. Guardianship is intended to protect a vulnerable adult, but it also results in a substantial loss of rights for that individual (Zimny & Grossberg, 1998). Clinical Evaluation in Adult Guardianship Judicial determination of capacity is a crucial component of all guardianship proceedings. Each state, through its statutes and case law, sets forth legal definitions and procedural requirements for determin- ing an individuals capacity (Anderer, 1990; Sabatino & Basinger, 2000). There is enormous variability in the role, scope, and format of clinician capacity assessment in these provisions. Currently, 30 states require a clin- ical evaluation of capacity prior to guardianship pro- ceedings, 15 states leave this decision to the discretion of the court, and 5 states provide no statutory...
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This note was uploaded on 12/01/2011 for the course CLP 7934 taught by Professor Staff during the Summer '08 term at University of Florida.
- Summer '08