Monday, 18 August 2003
This presentation is part of : Monday Poster Sessions

PA-018 Decision-Making Capacity (DMC) in Cognitively Impaired Older Adults: Research in Progress

Sara Horton-Deutsch1, Prudence Twigg1, and Rebecca Evans2. (1) School of Nursing, Indiana University, Indianapolis, IN, USA, (2) School of Medicine, Neurology, Indiana University, Indianapolis, IN, USA

Objective: The primary purpose of the study is to determine the decision-making capacity (DMC) of community-dwelling older adults with mild to moderate dementia.

Design: The study is descriptive, using quantitative and qualitative methods, with two data collection points about 6 weeks apart. 30 caregiver-care receiver dyads will be recruited.

Materials and Methods: 2 vignettes (therapeutic and research) will be presented to both caregivers (mostly spouses) and care receivers with mild to moderate dementia (MMSE=13-26). Questions to determine DMC were developed around the MacArthur templates (Grisso & Appelbaum). Repeat measures will be conducted on care receivers at 6 weeks after the initial data collection point. Responses at both the paraphrased recall and recognition levels will be scored. Additionally, audiotaped semi-structured interviews around issues of decision-making conducted with the care receivers. Statistical analysis will include consistency of care receiver decisions over time, comparisons between caregiver (mostly age-matched) and care receiver DMC, comparisons between caregiver proxy and care receiver decisions, and correlations between DMC and MMSE scores. Qualitative analysis will focus on examining intraindividual decision-making behaviors.

Results: The study is in progress. 10 dyads have participated. Preliminary findings show recognition scores are higher than recall scores for care receivers, varying congruence between caregiver and care receiver decisions, and that health care decisions of care receivers are grounded in previous decision-making experiences.

Conclusion: Final results and conclusions will be available at the time of presentation.

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