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Updated: Jun 18, 2026

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing
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Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Published on: January 24, 2020

Substituted decision making: elder guardianship.

Martha E Leatherman1, Katherine E Goethe

  • 1*Board certified geriatric psychiatrist in solo private practice daggerNeuropsychologist specializing in dementia. Together, they founded Dignity First, Inc., San Antonio, TX, which is dedicated to training caregivers of elders with dementia.

Journal of Psychiatric Practice
|November 26, 2009
PubMed
Summary

This guide helps clinicians perform psychiatric evaluations for adult guardianship (conservatorship). It clarifies medical, legal, and societal factors for substituted decision-making in elder care.

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Last Updated: Jun 18, 2026

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing
06:58

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Published on: January 24, 2020

Assessment of Age-related Changes in Cognitive Functions Using EmoCogMeter, a Novel Tablet-computer Based Approach
10:13

Assessment of Age-related Changes in Cognitive Functions Using EmoCogMeter, a Novel Tablet-computer Based Approach

Published on: February 14, 2014

Area of Science:

  • Psychiatry
  • Geriatrics
  • Forensic Psychology

Background:

  • The elderly population is growing, increasing the need for substituted decision-making.
  • Requests for guardianship (conservatorship) evaluations are becoming more complex.
  • Clinicians require guidance to navigate these complex legal and medical intersections.

Purpose of the Study:

  • To assist experienced clinicians in understanding and performing capacity evaluations for adult guardianship.
  • To clarify the medical, legal, and societal factors influencing substituted decision-making.
  • To improve the quality of psychiatric evaluations informing court decisions.

Main Methods:

  • This column synthesizes current medical, legal, and ethical considerations.
  • It provides a framework for evaluating decision-making capacity in adults.
  • Expert clinical insights are integrated with legal standards.

Main Results:

  • Clinicians will gain a better understanding of the judicial system's requirements for guardianship.
  • Effective performance of psychiatric evaluations for substituted decision-making is facilitated.
  • Improved communication with courts, patients, and families regarding psychiatric diagnoses is expected.

Conclusions:

  • Understanding adult guardianship is crucial for psychiatrists working with the elderly.
  • Accurate capacity evaluations support informed substituted decision-making.
  • This guidance enhances the clinician's role in legal and medical contexts.