Older Adults and Capacity-Related Assessment: Promise and Caution

Abstract

Data from 30 cognitively intact and emotionally stable Canadian elders provided support for the construct validity of the Hopemont Capacity Assessment Instrument and the Independent Living Scales. Subscale scores in the health or financial domains on these two capacity-related instruments were moderately correlated; weaker correlations were observed between ILS and HCAI subscales tapping discrepant domains. Training in thinking aloud and responding to hypothetical questions did not affect scores on these measures, nor were scores on brief depression and anxiety scales statistically associated with standing on capacity-related measures. Reading comprehension was associated with scores on the Hopemont Capacity Assessment Instrument.

The authors gratefully acknowledge the instrumental assistance and moral support of UNI∼COM and the Centres for Seniors Windsor in this study. The authors appreciate the assistance of Carrie McGregor in transcribing the audiotaped HCAI interviews. Susan MacNeill, Catherine Sarkisian, and Barry Edelstein generously responded to requests for information on the MacNeill-Lichtenberg Decision Tree, Expectations Regarding Aging-12 Scale, and the Hopemont Capacity Assessment Instrument, respectively. Harcourt Corporation, Canada, and the Nelson Company, Canada, provided a research discount for purchase of some of the test materials used in this study. This research was supported by a Start-up Grant from the University of Windsor and a University of Windsor Women's Grant to the first author.

Notes

^a Significantly skewed. The ratio of the skewness statistic to its SE (.42) is <−2.

Note. NDRT = Nelson-Denny Reading Test. For the self-ratings of current and past daily reading time, 1 = less than 1 h daily; 2 = 1 to 3 h per day; 3 = 3 to 6 h daily; and 4 = more than 6 h per day.

^a Significantly skewed. The ratio of the skewness statistic to its SE (.42) is <− 2 or >2.

Note. HCAI = Hopemont Capacity Assessment Interview; Medical = Medical Decision Making total raw score; Financial = Financial Decision Making total raw score; ILS = Independent Living Scales; Memory = Memory/Orientation Subscale T score; Money = Managing Money Subscale T score; Home = Managing Home and Transportation Subscale T score; and Health = Health and Safety Subscale T score. Monotrait heteromethod correlations are in bold print.

∗p < .05 (two-tailed).

Note. WTAR = Wechsler Test of Adult Reading; NDRT = Nelson-Denny Reading Test.

∗p < .05 (two-tailed test).