Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-26T13:34:54.754Z Has data issue: false hasContentIssue false

Testamentary capacity and delirium

Published online by Cambridge University Press:  01 July 2010

Benjamin Liptzin*
Affiliation:
Department of Psychiatry, Baystate Health, Springfield, MA, U.S.A.
Carmelle Peisah
Affiliation:
Academic Department for Old Age Psychiatry, Prince of Wales Hospital, and University of New South Wales, Sydney, Australia
Kenneth Shulman
Affiliation:
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
Sanford Finkel
Affiliation:
University of Chicago Medical School, Wilmette, IL., U.S.A.
*
Correspondence should be addressed to: Benjamin Liptzin, Department of Psychiatry, Baystate Health, 759 Chestnut Street, Springfield, MA 01199, U.S.A. Phone: +1 413-794-4235; Fax: +1 413-794-4234. Email: [email protected].

Abstract

Background: With the aging of the population there will be a substantial transfer of wealth in the next 25 years. The presence of delirium can complicate the evaluation of an older person's testamentary capacity and susceptibility to undue influence but has not been well examined in the existing literature.

Methods: A subcommittee of the IPA Task Force on Testamentary Capacity and Undue Influence undertook to review how to assess prospectively and retrospectively testamentary capacity and susceptibility to undue influence in patients with delirium.

Results: The subcommittee identified questions that should be asked in cases where someone changes their will or estate plan towards the end of their life in the presence of delirium. These questions include: was there consistency in the patient's wishes over time? Were these wishes expressed during a “lucid interval” when the person was less confused? Were the patient's wishes clearly expressed in response to open-ended questions? Is there clear documentation of the patient's mental status at the time of the discussion?

Conclusions: This review with some case examples provides guidance on how to consider the question of testamentary capacity or susceptibility to undue influence in someone undergoing an episode of delirium.

Type
Review Article
Copyright
Copyright © International Psychogeriatric Association 2010

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 Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Washington, DC: American Psychiatric Association.Google Scholar
Goodfellow, Banks v. (1870). LR5 QB, 549.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, 253266.CrossRefGoogle ScholarPubMed
Hull, R. and Hull, I. (1996). Suspicious circumstances in relation to testamentary capacity and undue influence. In Law Society of Upper Canada, Estates: Planning, Administration, and Litigation (pp. 7787), Special Lectures. Toronto: Carswell.Google Scholar
Inouye, S. K., van Dyck, C. H., Alessi, C. A., Balkin, S., Siegal, A. P. and Horwitz, R. I. (1990). Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Annals of Internal Medicine, 113, 941948.CrossRefGoogle Scholar
Liptzin, B. and Jacobson, S. (2009). Delirium. In Sadock, B. J., Sadock, V. A. and Ruiz, P. (eds.), Comprehensive Textbook of Psychiatry, 9th edn (pp. 40664073). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
McCartney, J. R. and Palmateer, I. M. (1985). Assessment of cognitive deficit in geriatric patients. Journal of the American Geriatrics Society, 33, 467471.CrossRefGoogle ScholarPubMed
Peisah, C., Brodaty, H. and Quadrio, C. (2006). Family conflict in dementia: prodigal sons and black sheep. International Journal of Geriatric Psychiatry, 21, 485492.CrossRefGoogle ScholarPubMed
Peisah, C. et al. for the International Psychogeriatric Association Task Force on Wills and Undue Influence (2009). The wills of older people: risk factors for undue influence. International Psychogeriatrics, 21, 715.CrossRefGoogle ScholarPubMed
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, 722727.CrossRefGoogle ScholarPubMed
Shulman, K. I., Peisah, C., Jacoby, R., Heinik, J. and Finkel, S. for the International Psychogeriatric Association Task Force on Testamentary Capacity and Undue Influence (2009). Contemporaneous assessment of testamentary capacity. International Psychogeriatrics, 21, 433439.CrossRefGoogle ScholarPubMed
Spar, J. E. and Garb, A. S. (1992). Assessing competency to make a will. American Journal of Psychiatry, 149, 169174.Google ScholarPubMed
Sprehe, D. J. and Kerr, A. L. (1996). Use of legal terms in will contests: implications for psychiatrists. Bulletin of the American Academy of Psychiatry and the Law, 24, 255265.Google ScholarPubMed