Impact of Medical Hospitalization on Treatment Decision-Making Capacity in the Elderly

doi:10.1001/archinte.1990.00040031717022

You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.

Vol. 150 No. 8, August 1990

Online Only
	•	Online First Table of Contents

Original Investigations

•	Online Features

This Article
•	References
•	Full text PDF
•	Reply to article
•	Send to a friend
•	Save in My Folder
•	Save to citation manager
•	Permissions

Citing Articles
•	Citation map
•	Citing articles on HighWire
•	Citing articles on Web of Science (59)
•	Contact me when this article is cited

Related Content
•	Similar articles in this journal

Social Bookmarking
	What's this?

Impact of Medical Hospitalization on Treatment Decision-Making Capacity in the Elderly

L. Jaime Fitten; Martha S. Waite

Arch Intern Med. 1990;150(8):1717-1721.

Abstract

A growing population of hospitalized elderly will need to makean increasing number of treatment decisions. No generally acceptedcriteria currently exist to assess the decision-making capacityof these elders. In this study, three hypothetical clinicalvignettes were developed to assess treatment decision-makingcapacity in 25 presumably competent, medically ill, nondistressed,hospitalized elders and 25 healthy, age- and education-matchedcontrols. The patients' understanding of the vignettes was evaluatedand compared with their understanding of a standard consentform; with their performance on a mini-mental state examination;and with physician judgments about their decisional capacity.Vignette results indicate a significant difference between studyand control groups in understanding of key treatment issues.Healthy controls demonstrated a better understanding of theseissues. Twenty-eight percent of the patients had significantdecisional impairments by vignette assessment but were not identifiedby mental status scores or physician judgments. Results suggestthat presumably competent, medically ill elders may be at riskfor developing decisional impairments during hospitalizationfor acute illness. Obtaining informed consent directly frommany of these patients may not be feasible.

(Arch Intern Med. 1990;150:1717-1721).

Add to CiteULike CiteULike Add to Connotea Connotea Add to Delicious Delicious Add to Digg Digg Facebook Add to Reddit Reddit Add to Technorati Technorati Twitter What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Does This Patient Have Medical Decision-Making Capacity?
Sessums et al.
JAMA 2011;306:420-427.
ABSTRACT | FULL TEXT

Assessment of Decision-Making Capacity in Older Adults: An Emerging Area of Practice and Research
Moye and Marson
J Gerontol B Psychol Sci Soc Sci 2007;62:P3-P11.
ABSTRACT | FULL TEXT

Capacity, consent, and selection bias in a study of delirium
Adamis et al.
J. Med. Ethics 2005;31:137-143.
ABSTRACT | FULL TEXT

Determining resuscitation preferences of elderly inpatients: a review of the literature
Frank et al.
CMAJ 2003;169:795-799.
ABSTRACT | FULL TEXT

Perceptions of Informed Consent in the Care of Elderly People in Five European Countries
Schopp et al.
Nurs Ethics 2003;10:48-57.
ABSTRACT

Decision-Making Capacity-Reply
Marson and Harrell
Arch Neurol 1996;53:589-590.
ABSTRACT

Assessing the Competency of Patients With Alzheimer's Disease Under Different Legal Standards: A Prototype Instrument
Marson et al.
Arch Neurol 1995;52:949-954.
ABSTRACT

Terminal Care of the Very Old: Changes in the Way We Die
Hesse
Arch Intern Med 1995;155:1513-1518.
ABSTRACT

Validation of a Decisional Conflict Scale
O'Connor
Med Decis Making 1995;15:25-30.
ABSTRACT

Do Clinical and Formal Assessments of the Capacity of Patients in the Intensive Care Unit to Make Decisions Agree?
Cohen et al.
Arch Intern Med 1993;153:2481-2485.
ABSTRACT

| | |