Principles and practice of geriatric assent

Area of Science:

• Gerontology
• Bioethics
• Clinical Practice

Background:

• Cognitively impaired older adults often face challenges in healthcare decision-making.
• Respecting patient autonomy is a core ethical principle in geriatric care.
• Existing clinical practices may not adequately incorporate the values of incapacitated patients.

Observation:

• Geriatric assent is defined as active collaboration between healthcare professionals and cognitively impaired patients.
• It emphasizes incorporating patients' longstanding values into major healthcare decisions.
• The paper aims to guide geriatric practitioners in applying geriatric assent in diverse clinical settings.

Findings:

• A case example and algorithm are provided to illustrate the implementation of geriatric assent.
• This framework helps practitioners maximize the input of incapacitated older adults.
• Geriatric assent facilitates shared decision-making, even with cognitive impairment.

Implications:

• Implementing geriatric assent preserves the autonomy of older adults.
• It promotes culturally sensitive care for diverse patient populations.
• This practice enhances respect for both current and future decision-making capacity.