Improving the assessment of decision-making capacity in patients with dementia
King, Paul R., Jr.
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Decision-making capacity is a medical/legal construct defined as the ability to (a) understand information relevant to an important personal decision, (b) appreciate probabilistic consequences, and (c) render a reliable and valid opinion. In the clinical setting, decision-making capacity refers to one's ability to make important life decisions regarding financial matters, health and illness, and activities of daily living. It is a complex construct, but one that clinicians are commonly challenged to assess. The general goal of this research is to determine if a new approach to decision-making capacity assessment will be useful in clinical settings. Two pilot studies were used here to investigate whether or not a prototype psychometric measure, consisting of a vignette-based structured interview, separates the performance of healthy persons from patients with dementia. The data, while preliminary, suggest that this may be an effective tool to help improve the assessment of decision-making capacity in dementia patients.