Assessment of Capacity of Older Adults: A Growing Challenge for Physicians

The 21st century is bringing about vast changes in the demographics of the United States. Notably, the population is aging at a rapid rate, and incidence of chronic illness and dementia is increasing, the disability population is aging, the nature of medical choices is changing due to evolving medical technology, and health care delivery systems are becoming increasingly complex. These trends bring health care clinicians up starkly against a growing challenge:

The Rising Tide of Patients With Diminished Decisional Capacity

Intended Audience

The proposed training will primarily target physicians (and secondarily medical students) including clinicians in acute and long-term care settings, outpatient facilities and office settings; and will include a diversity of medical disciplines such as internal medicine, geriatrics, neurology and psychiatry. While the training will target physicians, other professionals such as nurses, social workers, occupational therapists, psychologists and gerontologists also will find the curriculum useful.

Learning Objectives (CME, CNE, CEU)

Upon completion of this activity, participants will be able to:

• Properly evaluate your patient’s capacities
• Initiate a discussion of capacity with patients based on the ten key tenets of capacity assessment principles and practices
• Request a more thorough capacity evaluation for patients who are difficult to assess
• Prescribe a proper referral for capacity assessment
• Utilize appropriate terminology and examples when working with courts in guardianship proceedings

Accreditation and Designation Statements

Physicians

Rush University Medical Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Rush University Medical Center designates this enduring material for a maximum of four AMA PRA Category 1 credits. Physician should claim only credit commensurate with the extent of their participation in the activity.

Nurses and Social Workers

• This CE activity is being offered for four contact hours. This program satisfies the Illinois social worker three-hour ethics requirement.
• Attendance at the entire program and completion of the evaluation is required to obtain a CE certificate.
• Rush University is an approved provider of continuing education by the Illinois Department of Regulations and Licensing per the Illinois Administrative Code.
• This CE program is being presented without bias and without commercial support

Course components

Fee schedule:

• $200 for four Continuing Medical Education (CME) credits
• $100 for four Continuing Nursing Education (CNE) credits, four Continuing Education Units (CEU) or a Certificate of Completion
• $50 for students

This course is split into six modules and is expected to take no longer than five hours to complete. You have two months to complete the course.

You do not need to complete the entire course in one sitting. You will be able to log off and then log back on.

A course outline is available on the website to provide further details of course content.

There is a brief post-test (about five questions) at the end of each module. A score of 80 percent on each module quiz is required to receive continuing education credit.

A downloadable curriculum is available at no extra fee to each registrant of the course. A downloadable glossary and a resource page are also available.

This curriculum was made possible through the generous support of the Retirement Research Foundation.

For more information or to enroll, please contact Michelle Hochwert at decisional_capacity@rush.edu.  

Release date: Aug. 1, 2012. The opinions or views expressed in this educational program are those of the participants and do not necessarily reflect the opinions or recommendations of Rush University Medical Center. The faculty may have included discussion on unlabeled uses of a commercial product or an investigational use of a product not yet approved for this purpose. Please consult the full prescribing information before using any medication mentioned in this educational program. This educational activity has been produced in compliance with all ACCME Essential Areas and Elements and Accreditation Policies.
Expiration date: July 31, 2013.

CME Activity # IN13-005
CME Course Director

Anthony Perry, MD
Director of the Johnston R. Bowman Health Center
Associate professor
Department of Internal Medicine
Rush University Medical Center
Chicago, Illinois

Faculty

Amy Eisenstein, PhD
Assistant professor, College of Nursing
Rush University Medical Center
Chicago, Illinois

Sanford Finkel, MD
Clinical professor of psychiatry
University of Chicago Medical School
Chicago, Illinois

Robyn Golden, MA
Director of Rush Health and Aging
Rush University Medical Center
Chicago, Illinois

Charles Sabatino, JD
Director of the American Bar Association Commission on Law and Aging
Adjunct professor at Georgetown University Law Center
Washington, D.C.

Erica Wood, JD
Assistant director of the American Bar Association Commission on Law and Aging
Washington, D.C.

Gayle Shier, MSW
Program coordinator
Rush University Medical Center
Chicago, Illinois

Norman Ryan, MD
Senior medical director, Performance Improvement at Rush Health
Rush University Medical Center
Chicago, Illinois

Daniel Maher, RN, MSN, CNP
Gerontological nurse practitioner
Rush University Medical Center
Chicago, Illinois

Daniel Loiterstein, MD
St. Louis Veterans Affairs Medical Center
St. Louis, Missouri

CME Reviewer

Harold A. Kessler, MD
Associate dean, Post-Graduate Medical Education
Director, Office of Continuing Medical Education
Rush University Medical Center
Chicago, Illinois

All of the above have nothing to disclose.

Computer requirements

The following hardware and software are recommended to optimize your RULearning experience.
These requirements are suggested for your personal computers. Rush University Medical Center computers should not be altered.

Platform:
Windows XP, Vista, or Seven
MAC 10.4 and later (MAC 10.3 is not supported)

Hardware:
128 MB of RAM
2 GB of free disk space
Sound card with speakers (for listening to multimedia)
Ethernet or wireless network card for Internet connection
T1, DSL, Cable, or Satellite high-speed internet

Software:

• Java JRE plugin for Windows users (This is very important, it enables the system to work properly!!)
• Java for MAC OS X 10.5 users
• Java for MAC OS X 10.6 users
• Microsoft Office 2003 or newer (starting fall 2010 you will need 2007 or newer.)
• Microsoft file converters for 2007 files (This will help those with Office 2003 view files created in Office 2007.)
• Adobe Acrobat Reader
• Windows Media Player
• Quicktime
• Flip4Mac (This file will allow MAC users to view Windows Media Files using the Safari browser.)
• Flash Player
• Shockwave Player

Browsers:

Windows

Note 1: IE 6, Firefox 1.5, Firefox 2.0 and Google Chrome are not supported.

Note 2: IE 8 is only supported in Standards Mode.

Mac

Note 1: Safari 2.0 is not supported.

Note 2: Mac OS 10.3 is not supported.

Browser settings:

JavaScript and cookies must be enabled.

Pop-Up Blockers:

If you are unable to view discussion postings, quiz windows, and download links, then you need to configure your browser to allow pop ups for the URL for RULearning. (http://rulearning.rush.edu). Pop-up blockers work in the background while you are browsing the Internet. When they detect a pop-up window that might be an unwanted advertisement, the software automatically closes the window. This can prevent RULearning from performing properly.