Mental Health Service, VA Boston Healthcare System, Boston, MA, USA.
Psychology, New England Geriatric Research Education and Clinical Center, Boston, MA, USA.
Gerontol Geriatr Educ. 2021 Apr-Jun;42(2):268-276. doi: 10.1080/02701960.2019.1624258. Epub 2019 Jun 7.
Assessment of decision-making capacity of older adults is a growing area of practice but training opportunities are lacking. We present a needs assessment, program characteristics, pilot clinic process (= 52 referrals) and outcome training (= 4 interns) data for a capacity training clinic. Process data reveal that the training clinic provided consistent referrals (1 per week) across multiple capacity domains (independent living, treatment consent, and financial capacities), with 27% of referrals providing opportunities for training in protective services. Outcome data found three of the four interns reported proficient skills in capacity assessment, as well as improved skills in six areas related to capacity assessment: knowledge of limitations of assessment methods, person-environment interaction, identifying and applying ethical and legal standards, utilizing cognitive assessments, communicating results and recommendations, and assessing risk. The discussion shares lessons learned for the development of future training rotations and clinics in the capacity assessment.
评估老年人的决策能力是一个日益增长的实践领域,但培训机会匮乏。我们展示了一个能力培训诊所的需求评估、项目特征、试点诊所流程(= 52 个转介)和培训结果(= 4 名实习生)数据。流程数据显示,该培训诊所跨多个能力领域(独立生活、治疗同意和财务能力)提供了一致的转介(每周 1 次),其中 27%的转介提供了保护服务培训的机会。结果数据发现,4 名实习生中有 3 人报告说在能力评估方面技能熟练,并在与能力评估相关的六个领域提高了技能:评估方法局限性的知识、人与环境的相互作用、识别和应用道德和法律标准、利用认知评估、沟通结果和建议,以及评估风险。讨论分享了在能力评估方面未来培训轮转和诊所发展的经验教训。