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Executive function impairment and recidivism in adult protective services clients referred for a decision making capacity assessment
- Authors:
- TERRACINA Katherine A., AAMODT Whitley W., SCHILLERSTROM Jason E.
- Journal article citation:
- Journal of Elder Abuse and Neglect, 27(2), 2015, pp.91-99.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The objective of this study was to determine if recidivistic Adult Protective Services (APS) cases referred for a decision-making capacity assessment were more cognitively impaired than nonrecidivistic cases. A retrospective medical record review of neuropsychological and demographic data was gathered during decisional capacity assessments. Recidivistic clients were those referred to APS more than once; those with a single open case were nonrecidivistic. Mean neuropsychological test scores were compared between recidivistic (n = 138) and nonrecidivistic (n = 95) subjects. No significant differences were found for age, gender, ethnicity, education, or dwelling status. Both recidivistic and nonrecidivistic cases performed poorly in all cognitive domains. Recidivistic clients performed significantly worse on measures of executive function (CLOX1, EXIT25). Executive function impairments seem to be one risk factor for recidivism in APS referrals. With 60% of cases referred for decision capacity assessments being recidivistic, identifying risk factors may help identify when targeted interventions are indicated to preclude recurrence of abuse. (Publisher abstract)
Neuropsychological correlates of performance based functional status in elder adult protective services referrals for capacity assessments
- Authors:
- SCHILLERSTROM Jason E., et al
- Journal article citation:
- Journal of Elder Abuse and Neglect, 25(4), 2013, pp.294-304.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
High rates of executive function impairment had been previously identified in clients referred by Texas Adult Protective Services (APS) to geriatric psychiatry for decision-making capacity assessments. This study aims to determine the independent relationship between neuropsychological screening instruments, particularly instruments sensitive to executive function, and performance-based functional tasks in elder referrals. The retrospective medical review (n = 75/157 referrals completed all neuropsychological and functional assessments) revealed that only the Executive Interview (EXIT25) contributed independent variance to money management performance, telephone use ability, and summed performance. The study concludes that executive instruments may specifically inform decision-making capacity assessments. (Edited publisher abstract)