Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-26T21:54:19.552Z Has data issue: false hasContentIssue false
  • English
  • Français

Financial and testamentary capacity evaluations: procedures and assessment instruments underneath a functional approach

Published online by Cambridge University Press:  14 November 2013

Liliana B. Sousa ,
Mário R. Simões ,
Horácio Firmino  and
Carmelle Peisah
Liliana B. Sousa*
Affiliation:
Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo Comportamental (CINEICC), Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
Mário R. Simões
Affiliation:
Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo Comportamental (CINEICC), Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
Horácio Firmino
Affiliation:
Serviço de Psiquiatria. Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal for the International Psychogeriatric Association Task Force on Capacity
Carmelle Peisah
Affiliation:
School of Psychiatry, University of New South Wales, University of Sydney, Capacity Australia, Sydney, NSW, Australia, for the International Psychogeriatric Association Task Force on Capacity
*
Correspondence should be addressed to: Liliana B. Sousa, PhD (student), Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal. Phone: +351-918-414-941; Fax: +351-256-084-386. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Mental health professionals are frequently involved in mental capacity determinations. However, there is a lack of specific measures and well-defined procedures for these evaluations. The main purpose of this paper is to provide a review of financial and testamentary capacity evaluation procedures, including not only the traditional neuropsychological and functional assessment but also the more recently developed forensic assessment instruments (FAIs), which have been developed to provide a specialized answer to legal systems regarding civil competencies.

Methods:

Here the main guidelines, papers, and other references are reviewed in order to achieve a complete and comprehensive selection of instruments used in the assessment of financial and testamentary capacity.

Results:

Although some specific measures for financial abilities have been developed recently, the same is not true for testamentary capacity. Here are presented several instruments or methodologies for assessing financial and testamentary capacity, including neuropsychological assessment, functional assessment scales, performance based functional assessment instruments, and specific FAIs.

Conclusions:

FAIs are the only specific instruments intended to provide a specific and direct answer to the assessment of financial capacity based on legal systems. Considering the need to move from a diagnostic to a functional approach in financial and testamentary capacity evaluations, it is essential to consider both general functional examination as well as cognitive functioning.

Keywords

financial and testamentary capacityneuropsychological and functional assessmentforensic assessment instruments
Type
Review Article
Information
International Psychogeriatrics , Volume 26 , Issue 2 , February 2014 , pp. 217 - 228
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Bar Association Commission on Law and Aging and American Psychological Association. (2008). Assessment of Older Adults With Diminished Capacity: A Handbook for Psychologists. Washington, DC: American Bar Association and American Psychological Association.Google Scholar
Anderer, S. J. (1997). Developing an Instrument to Evaluate the Capacity of Elderly Persons to Make Personal Care and Financial Decisions. Unpublished doctoral dissertation, Allegheny University of Health Sciences, Philadelphia, PA.Google Scholar
Anderson, E. (2008). Cognitive change in old age. In Jacoby, R., Oppenheimer, C., Dening, T. and Thomas, A. (eds.), Oxford Textbook of Old Age Psychiatry (pp. 33–50). Oxford, UK: Oxford University Press.Google Scholar
Archer, R. P., Stredny, R. V. and Zoby, M. (2006). Introduction to forensic uses of clinical assessment instruments. In Archer, R. P. (ed.), Forensic Uses of Clinical Assessment Instruments (pp. 1–18). London: Lawrence Erlbaum.Google Scholar
Banks v Goodfellow. (1870). LR 5 QB 549. Queen's Bench Division (QBD).Google Scholar
Bertrand, R. M. and Willis, S. L. (1999). Everyday problem solving in Alzheimer's disease: a comparison of subjective and objective assessments. Aging and Mental Health, 3, 281–293. doi:10.1080/13607869956055.CrossRefGoogle Scholar
Black, E. L., Ross, T. J., Flanagan, T., Rabheru, K. and Breiter, H. J. (2007). A Financial Assessment & Capacity Test (FACT) for a Psychogeriatric Population: Development and Concurrent Validity. London: Research Insights of the Regional Mental Health Care.Google Scholar
Bucks, R. S., Ashworth, D. L., Wilcock, G. K. and Siegfried, K. (1996). Assessment of activities of daily living in dementia: development of the Bristol Activities of Daily Living Scale. Age and Aging, 25, 113–120. doi:10.1093/ageing/25.2.113.CrossRefGoogle ScholarPubMed
Cramer, K., Tuokko, H. A., Mateer, C. A. and Hultsch, D. F. (2004). Measuring awareness of financial skills: reliability and validity of a new measure. Aging and Mental Health, 8, 161–171. doi:10.1080/13607860410001649581.Google Scholar
Cullum, C. M., Saine, K., Chan, L. D., Martin-Cook, K., Gray, K. F. and Weiner, M. F. (2001). Performance-based instrument to assess functional capacity in dementia: the Texas Functional Living Scale. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 14, 103–108.Google Scholar
Earnst, K. S.et al. (2001). Loss of financial capacity in Alzheimer's disease: the role of working memory. Aging, Neuropsychology, and Cognition, 8, 109–119. doi:10.1076/anec.8.2.109.839.Google Scholar
Edelstein, B. (1999). Hopemont Capacity Assessment Interview Manual and Scoring Guide. Morgantown, WV: West Virginia University.Google Scholar
Fountoulakis, K. N. and Despos, K. (2008). Testamentary and financial competence issues in dementia. In Stoppe, G. (ed.), Competence Assessment in Dementia: On Behalf of the European Dementia Consensus Network (pp. 71–75). New York, NY: Springer-Verlag.CrossRefGoogle Scholar
Franzen, M. D. (2008). Neuropsychological evaluations in the context of competency decisions. In MacNeill, A. and Hartlage, L. C. (eds.), Handbook of Forensic Neuropsychology (pp. 505–518). New York, NY: Springer.Google Scholar
Frolik, L. A. (2001). The strange interplay of testamentary capacity and the doctrine of undue influence: are we protecting older testators or overriding individual preferences? International Journal of Law and Psychiatry, 24, 253–266.Google Scholar
Galasko, D.et al. (1997). An inventory to assess activities of daily living for clinical trials in Alzheimer's disease: the Alzheimer's disease cooperative study. Alzheimer Disease and Associated Disorders, 11 (Suppl. 2), 33–39.Google Scholar
Gélinas, I., Gauthier, L., McIntyre, M. and Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia. American Journal of Occupational Therapy, 53, 471–481. doi:10.5014/ajot.53.5.471.Google Scholar
Griffith, H. R.et al. (2003). Impaired financial abilities in mild cognitive impairment: a direct assessment approach. Neurology, 60, 449–457.Google Scholar
Griffith, H. R.et al. (2010). Magnetic resonance imaging volume of the angular gyri predicts financial skill deficits in people with amnestic mild cognitive impairment. Journal of the American Geriatrics Society, 58, 265–274. doi:10.1111/j.1532-5415.2009.02679.x.Google Scholar
Grisso, T. (ed.), (2003). Evaluating Competencies: Forensic Assessments and Instruments, 2nd ed. New York, NY: Kluwer.Google Scholar
Hafemeister, T. L. and Sales, B. D. (1984). Interdisciplinary evaluations for guardianships and conservatorships. Law and Human Behavior, 8, 335–354. doi:10.1007/BF01044700.Google Scholar
Hebert, K. R. and Marson, D. C. (2007). Assessment of financial capacity in older adults with dementia. In Qualls, S. H. and Smyer, M. A. (eds.), Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention (pp. 237–270). Hoboken, NJ: John Wiley.Google Scholar
Heilbronner, R. L. (2004). A status report on the practice of forensic neuropsychology. Clinical Neuropsychologist, 18, 312–326. doi:10.1080/13854040490501574.Google Scholar
Heilbrun, K., Marczyk, G. R., DeMatteo, D., Zillmer, E. A., Harris, J. and Jennings, T. (2003). Principles of forensic mental health assessment: implications for neuropsychological assessment in forensic contexts. Assessment, 10, 329–343. doi:10.1177/1073191103258591.Google Scholar
Hoskin, K. M., Jackson, M. and Crowe, S. F. (2005). Can neuropsychological assessment predict capacity to manage personal finances? A comparison between brain impaired individuals with and without administrators. Psychiatry, Psychology, and Law, 12, 56–67.CrossRefGoogle Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914–919. doi:10.1001/jama.1963.03060120024016.CrossRefGoogle Scholar
Keith, R. A., Granger, C. V., Hamilton, B. B. and Sherwin, F. S. (1987). The Functional Independence Measure: a new tool for rehabilitation. Advances in Clinical Rehabilitation, 1, 6–18.Google Scholar
Kennedy, K. M. (2012). Testamentary capacity: a practical guide to assessment of the ability to make a valid will. Journal of Forensic and Legal Medicine, 19, 191–195.CrossRefGoogle ScholarPubMed
Kershaw, M. M. and Webber, L. S. (2001). Dimensions of financial competence. Psychiatry, Psychology, and Law, 11, 338–319. doi:10.1375/1321871042707241.Google Scholar
Kershaw, M. M. and Webber, L. S. (2006). Financial Competence Assessment Inventory (FCAI): Administration and Scoring Manual. Melbourne, Australia: Matek.Google Scholar
Kershaw, M. M. and Webber, L. S. (2008). Assessment of financial competence. Psychiatry, Psychology, and Law, 15, 40–55. doi:10.1080/13218710701873965.Google Scholar
Kohlman, L. (1992). Kohlman Evaluation of Living Skills. Rockville, MD: American Occupational Therapy Association.Google Scholar
Lai, J. M. and Karlawish, J. (2007). Assessing the capacity to make everyday decisions: a guide for clinicians and an agenda for future research. American Journal of Geriatric Psychiatry, 15, 101–111.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186. doi:10.1093/geront/9.3_Part_1.179.CrossRefGoogle ScholarPubMed
Loeb, P. A. (1996). Independent Living Scales (ILS): Manual. San Antonio, TX: Pearson.Google Scholar
Loewenstein, D. and Acevedo, A. (2010). The relationship between instrumental activities of daily living and neuropsychological performance. In Marcotte, T. D. and Grant, I. (eds.), Neuropsychology of Everyday Functioning (pp. 93–112). New York, NY: Guilford Press.Google Scholar
Loewenstein, D. A.et al. (1989). A new scale for the assessment of functional status in Alzheimer's disease and related disorders. Journal of Gerontology: Psychological Sciences, 44, 114–121. doi:10.1093/geronj/44.4.P114.Google Scholar
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Mahurin, R. K., DeBettignies, B. H. and Pirozzolo, F. J. (1991). Structured assessment of independent living skills: preliminary report of a performance measure of functional abilities in dementia. Journal of Gerontology: Psychological Sciences, 46, 58–66. doi:10.1093/geronj/46.2.P58.Google Scholar
Marcotte, T. D., Scott, J. C., Kamat, R. and Heaton, R. K. (2010). Neuropsychology and the prediction of everyday functioning. In Marcotte, T. D. and Grant, I. (eds.), Neuropsychology of Everyday Functioning (pp. 5–38). New York, NY: Guilford Press.Google Scholar
Marson, D. C. and Hebert, K. (2005). Assessing civil competencies in older adults with dementia: consent capacity, financial capacity, and testamentary capacity. In Larrabee, G. L. (ed.), Forensic Neuropsychology: A Scientific Approach (pp. 334–377). Oxford, UK: Oxford University Press.Google Scholar
Marson, D. C.et al. (2000). Assessing financial capacity in patients with Alzheimer disease: a conceptual model and a prototype instrument. Archives of Neurology, 57, 877–884. doi:10.1001/archneur.57.6.877.Google Scholar
Marson, D. C., Triebel, K. and Knight, A. (2012). Financial capacity. In Demakis, G. J. (ed.), Civil Capacities in Clinical Neuropsychology: Research Findings and Practical Applications (pp. 39–68). Oxford, UK: Oxford University Press.Google Scholar
Mathuranath, P. S., George, A., Cherian, P. J., Mathew, R. and Sarma, P. S. (2005). Instrumental activities of daily living scale for dementia screening in elderly people. International Psychogeriatrics, 17, 461–474. doi:10.1017/S1041610205001547.CrossRefGoogle ScholarPubMed
Menne, H. L. and Whitlatch, C. J. (2007). Decision-making involvement of individuals with dementia. Gerontologist, 47, 810–819. doi:10.1093/geront/47.6.810.Google Scholar
Millán-Calenti, J. C., Tubío, J., Pita-Fernández, S., Rochette, S., Lorenzo, T. and Maseda, A. (2012). Cognitive impairment as predictor of functional dependence in an elderly sample. Archives of Gerontology and Geriatrics, 54, 197–201. doi:10.1016/j.archger.2011.02.010.Google Scholar
Moberg, P. J. and Rick, J. H. (2008). Decision-making capacity and competency in the elderly: a clinical and neuropsychological perspective. NeuroRehabilitation, 23, 403–413.Google Scholar
Moore, D. J., Palmer, B. W., Patterson, T. L. and Jeste, D. V. (2007). A review of performance-based measures of functional living skills. Journal of Psychiatry Research, 41, 97–118. doi:10.1016/j.jpsychires.2005.10.008.Google Scholar
Moye, J. (1996). Theoretical frameworks for competency in cognitively impaired elderly adults. Journal of Aging Studies, 10, 27–42.Google Scholar
Moye, J. and Marson, D. C. (2007). Assessment of decision-making capacity in older adults: an emerging area of practice and research. Journal of Gerontology: Psychological Sciences, 62B, P3–11.Google Scholar
Moye, J., Armesto, J. C. and Karel, M. J. (2005). Evaluating capacity of older adults in rehabilitation settings: conceptual models and clinical challenges. Rehabilitation Psychology, 50, 207–214. doi:10.1037/0090-5550.50.3.207.Google Scholar
Napier, K. K., Barrett, J. J., Hart, K. J., Mullins, M., Schmerler, J. T. and Kasckow, J. W. (2007). Judgments of financial abilities of severely mentally ill individuals: a comparison of self-report and an objective measure. Psychiatry, Psychology, and Law, 1, 315–326. doi:10.1375/pplt.14.2.315.Google Scholar
Okonkwo, O. C., Wadley, V. G., Griffith, H. R., Ball, K. and Marson, D. C. (2006). Cognitive correlates of financial abilities in mild cognitive impairment. Journal of the American Geriatrics Society, 54, 1745–1750. doi:10.1111/j.1532-5415.2006.00916.x.CrossRefGoogle ScholarPubMed
Okonkwo, O. C.et al. (2008). Awareness of deficits in financial abilities in patients with mild cognitive impairment: going beyond self-informant discrepancy. American Journal of Geriatric Psychiatry, 16, 650–659. doi:10.1097/JGP.0b013e31817e8a9d.CrossRefGoogle ScholarPubMed
O’Neill, N. and Peisah, C. (2011). Capacity and the Law. Sydney, Australia: Sydney University Press.Google Scholar
Peisah, C. and Shulman, K. I. (2012). Testamentary capacity. In Demakis, G. J. (ed.), Civil Capacities in Clinical Neuropsychology: Research Findings and Practical Applications (pp. 95–120). Oxford, UK: Oxford University Press.Google Scholar
Peisah, C.et al.(for the International Psychogeriatric Association Task Force on Wills and Undue Influence). (2009a). The wills of older persons: risk factors for undue influence. International Psychogeriatrics, 21, 7–15.Google Scholar
Peisah, C., Forlenza, O. and Chiu, E. (2009b). Ethics, capacity, and decision-making in the practice of old age psychiatry: an emerging dialogue. Current Opinion Psychiatry, 22, 519–521. doi:10.1097/YCO.0b013e32833058e3.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H., Chance, J. M. and Filos, S. (1982). Measurement of functional activities of older adults in the community. Journal of Gerontology, 37, 323–329. doi:10.1093/geronj/37.3.323.Google Scholar
Pinsker, D. M., Pachana, N. A., Wilson, J., Tilse, C. and Byrne, G. J. (2010). Financial capacity in older adults: a review of clinical assessment approaches and considerations. Clinical Gerontologist, 33, 332–346. doi:10.1080/07317115.2010.502107.Google Scholar
Posener, H. D. and Jacoby, R. (2002). Testamentary capacity. In Jacoby, R. and Oppenheimer, C. (eds.), Psychiatry in the Elderly (pp. 932–940). New York, NY: Oxford University Press.Google Scholar
Razani, J.et al. (2011). Patterns of deficits in daily functioning and cognitive performance of patients with Alzheimer disease. Journal of Geriatric Psychiatry and Neurology, 24, 23–32. doi:10.1177/0891988710390812.Google Scholar
Sahadevan, S., Chin, J. J., Yap, M. N. M. and Yeoh, O. E. (2003). Assessing decision-making capacity in dementia patients: a semi-structured approach. Annals of the Academy of Medicine Singapore, 32, 749–755.Google ScholarPubMed
Sherod, M. G.et al. (2009). Neurocognitive predictors of financial capacity across the dementia spectrum: normal aging, mild cognitive impairment, and Alzheimer's disease. Journal of the International Neuropsychological Society, 15, 258–267. doi:10.1017/S1355617709090365.Google Scholar
Shulman, K. I., Cohen, C. A., Kirsh, F. C., Hull, I. M. and Champine, P. R. (2007). Assessment of testamentary capacity and vulnerability to undue influence. American Journal of Psychiatry, 164, 722–727. doi:10.1176/appi.ajp.164.5.722.Google Scholar
Shulman, K. I., Peisah, C., Jacoby, R., Heinik, J. and Finkel, S. (2009). Contemporaneous assessment of testamentary capacity: a consensus report from the IPA Task Force on testamentary capacity and undue influence. International Psychogeriatrics, 21, 433–439. doi:10.1017/S1041610209008874.Google Scholar
Slovenko, R. (2006). Civil competency. In Weiner, I. B. and Hess, A. K. (eds.), The Handbook of Forensic Psychology (pp. 190–209). Hoboken, NJ: John Wiley.Google Scholar
Sorger, B. M., Rosenfeld, B., Pessin, H., Timm, A. K. and Cimino, J. (2007). Decision-making capacity in elderly, terminally ill patients with cancer. Behavioral Sciences and the Law, 25, 393–404. doi:10.1002/bsl.764.Google Scholar
Sousa, L. B., Simões, M. R., Pires, L., Vilar, M. and Freitas, S. (2008). Adults and Older Adults Functional Assessment Inventory [Inventário de Avaliação Funcional de Adultos e Idosos, IAFAI]. Coimbra, Portugal: Faculty of Psychology and Educational Sciences, University of Coimbra.Google Scholar
Sousa, L. B., Simões, M. R. and Firmino, H. (2010). Financial Capacity Assessment Instrument [Instrumento de Avaliação da Capacidade Financeira, IACFin]. Coimbra, Portugal: Faculty of Psychology and Educational Sciences, University of Coimbra.Google Scholar
Spar, J. E. and Garb, A. S. (1992). Assessing competency to make a will. American Journal of Psychiatry, 149, 169–174.Google Scholar
Spar, J. E., Hankin, M. and Stodden, A. B. (1995). Assessing mental capacity and susceptibility to undue influence. Behavioral Sciences and the Law, 13, 391–403. doi:10.1002/bsl.2370130307.Google Scholar
Streisand, A. F. and Spar, J. E. (2008). A lawyer's guide to diminishing capacity and effective use of medical experts in contemporaneous and retrospective evaluations. ACTEC Journal, 33, 180–194.Google Scholar
Suto, W. M. I., Clare, I. C. H., Holland, A. J. and Watson, P. C. (2005). Capacity to make financial decisions among people with mild intellectual disabilities. Journal of Intellectual Disability Research, 49, 199–209. doi:10.1111/j.1365-2788.2005.00635.x.Google Scholar
Wadley, V. G., Harrell, L. E. and Marson, D. C. (2003). Self- and informant report of financial abilities in patients with Alzheimer's disease: reliable and valid? Journal of the American Geriatrics Society, 51, 1621–1626. doi:10.1046/j.1532-5415.2003.51514.x.Google Scholar
Webber, L. S., Reeve, R. A., Kershaw, M. M. and Charlton, J. L. (2002). Assessing financial competence. Psychiatry, Psychology and Law, 9, 248–256. doi:10.1375/pplt.2002.9.2.248.Google Scholar
Willis, S. L. (1990). Everyday Problems Test. Philadelphia, PA: Pennsylvania State University.Google Scholar
Willis, S. L. (1994). Test Administration Manual for Everyday Problems for Cognitively Challenged Elderly (EPCCE). Philadelphia, PA: Pennsylvania State University.Google Scholar
Wood, S. (2007). The role of neuropsychological assessment in capacity evaluations. In Qualls, S. H. and Smyer, M. A. (eds.), Changes in Decision-Making Capacity in Older Adults: Assessment and Intervention (pp. 191–204). Hoboken, NJ: John Wiley.Google Scholar
World Health Organization. (2000). WHODAS-II Disability Assessment Schedule: Training Manual, a Guide to Administration. Geneva, Switzerland: World Health Organization.Google Scholar
World Health Organization. (2002). Active Aging: A Police Framework. Geneva, Switzerland: World Health Organization.Google Scholar