Outcomes of a Decision-Making Capacity Assessment Model at the Grey Nuns Community Hospital
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Setting
2.2. Process of DMCA
2.3. Outcome Measures and Analysis
3. Results
3.1. Domains Identified in the Patients
3.2. Disciplines Involved and Referrals Made
3.3. Process
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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% (n/N) | |
---|---|
Age | 76 years old (SD: 10.5; Range: 49–98) |
Sex | Females: 51.1% (45/88) Males: 48.9% (43/88) |
Patient’s Living Arrangements | |
Home | 97.5% (77/79) |
Supportive Living/Long Term Care | 2.5% (2/79) |
DMCA performed | 72.6% (61/84) |
Diagnosis of Dementia | |
With Dementia | 43.2% (38/88) |
Unspecified Cognitive Impairment | 13.6% (12/88) |
No Dementia | 42.2% (38/88) |
Presence of Valid Trigger for DMCA | |
---|---|
Yes | 93.0% (80/86) |
No | 7.0% (6/86) |
Number of Domains Identified (all) | |
1 | 13.2% (9/68) |
2 | 29.4% (20/68) |
3 | 25.0% (17/68) |
4 | 30.9% (21/68) |
5 | 1.5% (1/68) |
Domains Identified for DMCA | |
Accommodation | 88.2% (60/68) |
Healthcare | 83.8% (57/68) |
Finances | 61.8% (42/68) |
Legal Affairs | 36.8% (25/68) |
Others (Employment, Social, Educational) | 7.4% (5/68) |
Number of Disciplines Involved in the DMCA | |
None | 1.7% (1/58) |
1 | 43.1% (25/58) |
2 | 24.1% (14/58) |
3 | 24.1% (14/58) |
4 | 6.9% (4/58) |
Types of Disciplines Involved in the DMCA | |
Social Worker | 81.0% (47/58) |
Occupational Therapist | 53.4% (31/58) |
Physicians | 22.4% (13/58) |
LPN/RN/NP | 19.0% (11/58) |
Medical Student | 10.3% (6/58) |
Geriatrics/Psychiatry | 3.4% (2/58) |
Physical Therapy | 1.7% (1/58) |
Number of Referrals Made During the DMCA Process | |
None | 3.4% (3/88) |
1 | 61.4% (54/88) |
2 | 27.3% (24/88) |
3 | 4.5% (4/88) |
4 | 3.4% (3/88) |
Types of Referrals | |
Geriatrics | 87.5% (77/88) |
Social Worker | 25.0% (22/88) |
Psychiatry | 15.9% (14/88) |
Occupational Therapist | 9.1% (8/88) |
Others (DCA, Ethics, Family Medicine, Neuropsychiatry) | 4.6% (4/88) |
Capacity Assessment Process Worksheet Used | |
Yes | 63.2% (55/87) |
No | 36.8% (32/87) |
Team Conference Held | |
Yes | 28.9% (24/83) |
No | 71.1% (59/83) |
Capacity Interview Done | |
Yes | 20.7% (18/87) |
No | 79.3% (69/87) |
Final Disposition | |
Has Capacity | 23.5% (20/85) |
Lacks Capacity | 48.2% (41/85) |
Capacity Assessment Not Required | 8.2% (7/85) |
Unknown | 20.0% (17/85) |
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Charles, L.; Kothavade, U.; Brémault-Phillips, S.; Chan, K.; Dobbs, B.; Tian, P.G.J.; Polard, S.; Parmar, J. Outcomes of a Decision-Making Capacity Assessment Model at the Grey Nuns Community Hospital. Int. J. Environ. Res. Public Health 2022, 19, 1560. https://doi.org/10.3390/ijerph19031560
Charles L, Kothavade U, Brémault-Phillips S, Chan K, Dobbs B, Tian PGJ, Polard S, Parmar J. Outcomes of a Decision-Making Capacity Assessment Model at the Grey Nuns Community Hospital. International Journal of Environmental Research and Public Health. 2022; 19(3):1560. https://doi.org/10.3390/ijerph19031560
Chicago/Turabian StyleCharles, Lesley, Utkarsha Kothavade, Suzette Brémault-Phillips, Karenn Chan, Bonnie Dobbs, Peter George Jaminal Tian, Sharna Polard, and Jasneet Parmar. 2022. "Outcomes of a Decision-Making Capacity Assessment Model at the Grey Nuns Community Hospital" International Journal of Environmental Research and Public Health 19, no. 3: 1560. https://doi.org/10.3390/ijerph19031560