Financial and personal competence in the elderly. The position of the Canadian Psychiatric Association

The assessment of competence in the elderly is an assessment of functional ability and not merely the act of establishing a diagnosis. The recommendations outlined above offer a model for such an assessment. In most cases, the decision is straightforward and the assessment not unduly time consuming. In a small number of cases, the circumstances and clinical features will make intensive and extensive study necessary to form a well considered opinion. The psychiatrist is wise to recognize those cases in which, for whatever reason he/she is not able to offer a considered certain opinion. To be a credible witness before the court, a physician must have a good mastery of the necessary data and present it clearly in a fashion which allows the court to consider criteria. The clinician must be familiar with the relevant provincial legislation with respect to appeals, change in status, etc. An opinion with respect to competence must reflect consideration of functioning in the present and in the recent past, as well as, the future implications implicit in the diagnosis. However, it remains an assessment of the ability to function at the time of the examination. The clinical state of competence or incompetence is of course subject to change and this may or may not come to be reflected in the legal status of the person.