Who can stay at home? Assessing the capacity to choose to live in the community
Who can stay at home? Assessing the capacity to choose to live in the community
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DOI：
10.1001/archinte.164.4.357
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发表时间：
2004-02-23
影响因子：
--
通讯作者：
Hurme, SB
中科院分区：
文献类型：
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作者：
Cooney, LM;Kennedy, GJ;Hurme, SB
虽然法院负有最终责任，但医生往往被要求评估老年人在社区中继续独居的能力。一个人做出这种决定的能力可能比做出医疗决定的能力更难评估。不安全的行为本身并不限制个人的选择。无法理解这些行动的含义也可能限制这种选择。决策能力并不能很好地通过认知功能的全球测试来衡量。执行功能的缺陷会导致洞察力、解决问题的能力和目标导向的计划能力受损，从而限制了一个人做出和执行决策的能力。不安全的行动和执行功能的缺陷，加上拒绝接受家庭和社会机构的帮助，可能表明在社区独立生活存在不可接受的风险。
While the courts have final responsibility, physicians are often asked to evaluate the ability of an older individual to remain living alone in the community. A person's capacity to make this decision can be more difficult to assess than the capacity to make medical decisions. Unsafe actions alone do not restrict the choice of individuals. Inability to understand the implications of these actions may also limit this choice. Decision-making ability is not well measured by global tests of cognitive function. Deficits in executive function resulting in impaired insight, problem-solving ability, and goal-directed planning limit one's ability to make and carry out decisions. Unsafe actions and deficits in executive function, combined with the refusal to accept help from family and social agencies, may indicate that independent living in the community presents unacceptable risks.