Accreditation The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation Statement: The American Medical Directors Association designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AMDCP Credit Designation: This session has been approved for a total of clinical 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).
Session Description: This session will present an overview of issues related to decision-making in long term care, as well as the U-CARE model for capacity assessment (assessment of understanding, consistency, appreciation of consequences, reasoning, and expression). Discussion will include addressing changes in capacity, as well as variation in the standard for capacity as related to the complexity of the decision and the resident’s present capabilities. Additionally, cases will be examined to illustrate the principles discussed.
Discuss basic principles of decision-making capacity and assessment.
Define the differences between capacity assessment, informed consent and competence.
Utilize the model provided (U-CARE) to conduct and document a resident’s decision-making capacity.
Relate decision-making to "risky" decisions, e.g., refusal, non-adherence or making "bad" decisions that are not due to incapacity.
Speaker(s): Rebecca L. Ferrini, MD, MPH, CMD; Robert M. Gibson, PhD, JD
Reference(s): Appelbaum P. S., Assessment of Patients’ Competence to Consent to Treatment, N Engl J Med 2007;357:1834-40. Grisso, T. & Appelbaum, P. (1998). Assessing competence to consent to treatment. New York: Oxford. Lyden, M., Assessment of Sexual Consent Capacity, Sex Disabil (2007) 25:3–20
MD, MPH, CMD,
County of San Diego, Health and Human Services, Edgemoor DP SNF