Capacity assessment training in geropsychology: Creating and evaluating an outpatient capacity clinic to fill a training gap

ABSTRACT

Assessment of decision-making capacity of older adults is a growing area of practice but training opportunities are lacking. We present a needs assessment, program characteristics, pilot clinic process (n= 52 referrals) and outcome training (n= 4 interns) data for a capacity training clinic. Process data reveal that the training clinic provided consistent referrals (1 per week) across multiple capacity domains (independent living, treatment consent, and financial capacities), with 27% of referrals providing opportunities for training in protective services. Outcome data found three of the four interns reported proficient skills in capacity assessment, as well as improved skills in six areas related to capacity assessment: knowledge of limitations of assessment methods, person-environment interaction, identifying and applying ethical and legal standards, utilizing cognitive assessments, communicating results and recommendations, and assessing risk. The discussion shares lessons learned for the development of future training rotations and clinics in the capacity assessment.

KEYWORDS:

• Capacity assessment
• outpatient assessment
• internship training
• geropsychology

Acknowledgments

This research was partially supported by the Office of Academic Affiliations, Department of Veterans Affairs. The contents of this article do not represent the views of the US Department of Veterans Affairs or the United States Government. This material is the result of work supported with resources and the use of facilities at the VA Boston Healthcare System.

Notes

1. Intermediate competency is described as “some exposure and experience, ongoing supervision needed” and advanced competency is described as “solid experience, handles typical situations well, supervision for unusual or complex situations is needed.”