Geriatric Forensic Report Writing

2017 ◽  
Author(s):  
Sherif Soliman ◽  
Phillip J. Resnick
Keyword(s):  
The Elderly ◽  
Decision Makers ◽  
Undue Influence ◽  
Geriatric Population ◽  
Basic Principles ◽  
Report Writing ◽  
Testamentary Capacity ◽  
Psychiatric Expertise ◽  
Forensic Psychiatric ◽  
Psychiatric Issues

As the population ages, expertise in addressing forensic psychiatric issues that arise in the geriatric population is becoming increasingly important. These include the need for guardianship, contractual capacity, testamentary capacity (capacity to make a will), and undue influence. Legal decision-makers frequently rely on psychiatric expertise. The geriatric-forensic psychiatric report is a key part of communication between the medical and legal professions. Often the report is the doctor’s only opportunity to communicate his or her opinion, since the vast majority of cases do not go to trial. This chapter focuses on planning, writing, and editing forensic psychiatric reports regarding geriatric issues. Basic principles of writing for a legal audience are discussed and how these principles apply to forensic psychiatric reports involving the elderly. The chapter offers recommendations for each stage of the writing process and discusses common pitfalls in writing forensic reports.

Capacity in the Life Course of the Elder

2017 ◽  
Author(s):  
Yaser Haq ◽  
Stuart A. Anfang ◽  
Benjamin Liptzin
Keyword(s):  
Elderly Population ◽  
Power Of Attorney ◽  
Complex Interplay ◽  
Undue Influence ◽  
Estate Planning ◽  
Retrospective Assessment ◽  
Testamentary Capacity ◽  
Low Threshold ◽  
The Life Course ◽  
Psychiatric Issues

Over the next few decades, there will likely be an increase in the frequency of will challenges related to testamentary capacity and undue influence, given a U.S. elderly population with a disproportionate amount of wealth. Psychiatric clinicians are likely to be called upon to advise the courts about a person’s capacity to make a will or susceptibility to undue influence. This chapter reviews the important legal and psychiatric issues involved in determinations of testamentary capacity and undue influence. It also touches on the policy considerations of promoting liberty and autonomy which set a low threshold for testamentary capacity while allowing for the doctrine of undue influence as a mechanism to protect those who are vulnerable. The complex interplay between cognition, a potentially conflictual milieu, and the extent of the assets at stake is also discussed. This chapter also provides guidance with respect to some of the challenges faced by clinicians conducting a contemporaneous versus retrospective assessment. Finally, mechanisms to avoid estate litigation, such as power of attorney and estate planning, are also discussed.

scholarly journals Forensic psychiatry determination of mental capacity

2011 ◽  
Vol 139 (7-8) ◽  
pp. 548-554
Author(s):  
Aleksandar Jovanovic ◽  
Srdjan Milovanovic ◽  
Miroslava Jasovic-Gasic
Keyword(s):  
Informed Consent ◽  
Forensic Psychiatry ◽  
Medical Data ◽  
Mental Capacity ◽  
Social Significance ◽  
Undue Influence ◽  
Basic Principles ◽  
Legal Implications ◽  
Testamentary Capacity

Forensic psychiatry determination is, ordered by a court, the analysis and interpretation of medical facts with important legal implications. In that sense, psychiatrists (or neuropsychiatrists), apart from their professional expertise, must be familiar with legal, economical and social significance of medical data, so that their forensic reports are clear and useful in the context of legal procedure. This review deals with forensic psychiatry aspects of mental capacity. In the introduction of the article, the explanation of relevant concepts such as mental capacity, contractual and testamentary capacity, informed consent, undue influence and forensic determination in light of Serbian statutory law is presented. Further, the authors present basic principles of making forensic reports on mental capacity as well as contractual and testamentary capacity, and informed consent for eventual medical examination and treatment.

Effectiveness of the Complete Health Improvement Program in a Geriatric Population

2021 ◽  
pp. 155982762110493
Author(s):  
Emily Scriven ◽  
Bhakti Chavan ◽  
David Drozek
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Lipoprotein Cholesterol ◽  
Health Improvement ◽  
Cvd Risk ◽  
Improvement Program ◽  
Geriatric Population ◽  
Complete Health

The Complete Health Improvement Program (CHIP) is an intensive therapeutic lifestyle modification program (ITLMP) with well-documented success in decreasing risk factors for cardiovascular disease (CVD). Plant-based diets and physical activity are components of the program that contribute to these improvements. Yet, there are few studies on how ITLMPs affect risk factors specifically for the geriatric population. The goal of this study was to examine results of CHIP participants with a focus on the older (greater than 65 years) population in Athens, Ohio. Retrospective data from 2011 to 2017 were analyzed for 26 CHIP classes. Recorded variables included body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), blood glucose (BG), and exercise level. Among geriatric participants, significant changes were found in BMI, BP, TC, LDL, HDL, BG, and exercise level ( P < .001). As compared to the younger population, changes in variables were equivalent in the geriatric population in all variables ( P > .05). These improvements in CVD risk factors among the elderly support the hypothesis that CHIP should be considered for CVD prevention and treatment in the geriatric population.

Is There a Need for Elderly Forensic Psychiatric Services?

2005 ◽  
Vol 45 (2) ◽  
pp. 154-160 ◽  
Author(s):  
I O Nnatu ◽  
F Mahomed ◽  
A Shah
Keyword(s):  
Mental Illness ◽  
Old Age ◽  
The Elderly ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Court Diversion ◽  
Mental Health Difficulties ◽  
Old Age Psychiatry ◽  
Forensic Psychiatric ◽  
Developed Nations

The population of the elderly in most developed nations is on the increase. Furthermore, the prevalence of mental disorder amongst elderly offenders is high. The true extent of `elderly' crime is unknown because much of it goes undetected and unreported. This leads to a failure to detect mental illness in such offenders. Court diversion schemes may improve recognition of mental illness but these schemes usually tend to deal with the more severe crimes. This may result in an overestimation of the amount of serious crime committed by the elderly and a failure to detect mental illness amongst those who commit less serious crimes. Efforts to service this hidden morbidity call for multi-agency collaboration. Improved detection and reporting of crimes is essential if mental health difficulties in the elderly are not to go unnoticed. The needs of elderly mentally-disordered offenders are complex and fall within the expertise of old age and forensic psychiatry, without being adequately met by either one. Therefore, consideration should be given to the development of a tertiary specialist forensic old-age psychiatry service.

The Mental Capacity Act 2005 best interests test as applied to the elderly – is it fit for purpose?

2018 ◽  
Vol 86 (3) ◽  
pp. 142-146
Author(s):  
Emma M Szelepet
Keyword(s):  
The Elderly ◽  
Mental Capacity ◽  
The Body ◽  
Best Interests ◽  
Human Flourishing ◽  
Undue Influence ◽  
Mental Capacity Act 2005 ◽  
Physical Risk ◽  
Fit For Purpose ◽  
Mental Capacity Act

The Mental Capacity Act 2005 (‘MCA’) sets out a regime which governs the making of decisions for people who lack mental capacity. Acts must be carried out, and decisions made, for such an incapacitated person, based on what is in her best interests (section 4 MCA). In this paper, I consider the body of post-MCA case law which applies the MCA best interests test to decision-making for elderly people, in various contexts. Is the best interests test ‘fit for purpose’ for the vulnerable elderly? The key aims of Parliament in introducing the test seem to have been empowerment, protection and support – and alertness to undue influence – as well as a balance between the objective and subjective viewpoints. Laudable attempts have been made by some judges, applying the MCA, to pay real heed to the patient's wishes and values, and to balance physical risk with welfare and happiness. However, it is not yet clear in my view that the new regime fully achieves Parliament’s aims. Indeed, these aims themselves should be expanded; the law in this area should also promote the significance and value of advanced years and should recognise Aristotle's concept of ‘human flourishing’ in old age. Consideration should be given to amending the MCA, adding guidance specifically for the elderly and also to introducing a Convention of Human Rights for the older person and to creating a new statutory Older Persons’ Commissioner and/or a cabinet-level Minister for Ageing and Older People.

scholarly journals Geriatric oral health concerns, a dental public health narrative

2019 ◽  
Vol 6 (2) ◽  
pp. 883
Author(s):  
Ramprasad Vasthare ◽  
Anil V. Ankola ◽  
Arron Lim Yan Ran ◽  
Prateek Mansingh
Keyword(s):  
Public Health ◽  
Oral Health ◽  
Healthy Aging ◽  
Dental Health ◽  
The Elderly ◽  
Dental Public Health ◽  
Cognitive Changes ◽  
Geriatric Population ◽  
Health Concerns ◽  
Treatment Services

Across the world, the segment of the elderly in populations is seen to be increasing at a rapid rate. There also exists a trend in which more teeth are retained as age increases due to effective dental public health measures like fluoridation. This inevitably places an increased need for dental healthcare among the geriatric populations. Since oral health greatly affects the systemic health of aged individuals, it is imperative for dentists and physicians to work together as a team to impart treatment to the best of one’s abilities for geriatric patients. It is therefore, necessary to first assess the oral health concerns surrounding the geriatric population from the perspective of public health dentistry. Relationship of the elderly with periodontal disease, dental caries, salivary hyposalivation and xerostomia, cognitive changes, and simultaneous usage of diverse medications was discussed. This paper reviewed the literature and then examined and discussed the various problems mentioned in depth and suggested recommendations for a plan of action. Knowledge about the specific oral health concerns and issues will help to better position us in developing strategies for providing better oral healthcare to the geriatric population in addition to the existing systemic healthcare. In the future, the elderly will make up a huge portion of the demographic visiting dentist regularly for a myriad of oral health problems. Dental health professionals therefore, must have adequate training and competency to deal with the predicament of this geriatric population. Preventive and treatment services can ensure healthy aging which will improve the quality of life.

scholarly journals OLD AGE HOMES: ARE THEY ACCEPTABLE TO PAKISTANI GERIATRIC POPULATION? RESULTS OF A SURVEY OF ELDERLY OUTPATIENTS VISITING TEACHING HOSPITALS IN KARACHI, PAKISTAN

2018 ◽  
Vol 8 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Waris Qidwai ◽  
Imdad Ali Khushk ◽  
Fizzah Farooq ◽  
Muhammad Yusuf Hafiz ◽  
Kashmira Nanji
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Chi Square ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Term Care ◽  
Old Age Homes

Background: Worldwide, some one million people pass the sixty year old threshold every month (Ageing, WHO). Between 2010 and 2050, the number of older people in less developed countries is projected to increase. Methods: Cross-sectional study conducted in Outpatient clinics (OPD) of two hospitals in Karachi from April to May 2013. Elderly (> 60 years of age) visiting the clinics were consecutively recruited. 477 elderly were approached and a pretested, structured questionnaire was used to obtain information. Data was analyzed using SPSS version 19 and Pearson chi-square test was used to identify the factors related to choosing of "Old Age Homes". Results: A total of 400 participants were selected. Fifty-five percent of the elderly were in between 60 to 65 years of age and majority was males 54.8 percent. Elderly were aware of the presence of "Old Age Homes" in Pakistan, however only 7 percent choose to live in there. The main reason was found to be that the elderly did not want to go away from their families and loved ones. Conclusion: In conclusion, majority of the participants felt insecure to live in a home with strangers. However, "Old Age Homes" were preferred choice for those with chronic diseases or those living alone. Media should initiate public education programs to reduce social stigmas in seeking alternate long-term care services outside of the family.

Case Series of Skull Base Meningioma Resection in the Octogenarian Population

2021 ◽  
Author(s):  
Dorian M. Kusyk ◽  
Gordon Mao ◽  
Rocco Dabecco ◽  
Alexander K. Yu
Keyword(s):  
Skull Base ◽  
Case Series ◽  
The Elderly ◽  
Outcome Data ◽  
Skull Base Tumor ◽  
Geriatric Population ◽  
Perioperative Morbidity ◽  
Wide Range ◽  
Potential Risk Factors ◽  
Skull Base Meningiomas

Abstract Introduction The geriatric population is the fastest growing segment of the American population, and octogenarians are increasingly seen by neurosurgeons for relatively common lesions such as meningiomas. Unfortunately, providers do not have clear data to guide decision-making regarding these lesions, particularly if they involve the skull base. Current research in outcomes among the elderly looks at a wide range of ages, often anyone older than 65. Previous studies in octogenarians report a wide-range of mortality rates and do not focus on skull base lesions. This paper strives to clarify the experiences and outcomes of octogenarians. Patients and Methods This retrospective series reviews skull base tumor surgeries performed at a single academic institution over the past 15 years in octogenarian patients. Primary endpoint was 30-day mortality; however, potential risk factors, perioperative morbidity, postdischarge disposition, and longer term follow-up were also captured. Multivariate logistic regression was performed to identify relevant perioperative and medical characteristics that increases the risk of adverse events. Results Fourteen patients underwent craniotomies for skull base procedures with an average age of 84.5, with a 14% 30-day mortality rate. One patient required a tracheostomy on discharge and approximately half were able to either go home or rehabilitation after their procedure. On statistical analysis, there were no noted characteristics that predisposed any of the patients to a poorer outcome. Conclusion Octogenarian patients were able to tolerate surgery for skull base meningiomas resection. This outcome data may be used to inform surgical decision and guide conversation with patients and their families.

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