| The primary aim of this research is to characterize the practice experiences of psychologists that conduct medical decisions-making capacity (MDC) assessments among geriatric patients. Thus, this study surveyed 94 psychologists, who participate in MDC assessments of geriatric patients, to describe their practice experience with frequency data through descriptive statistics, and offer suggestions for future research in order to build an evidence based practice model. The results of this research have key implications with six central tenants. First, the study results suggest that MDC assessment is germane to psychologists that work with geriatric patients, and therefore training on MDC assessment is recommended for psychologists who practice with geriatric patients. Second, the results suggest that there is a divergence between the actual self-perceived level of MDC knowledge and the relevancy of MDC knowledge to psychologists' practice. Therefore research is strongly recommended to develop a standardized training model for MDC with specific goals, objectives, and competencies in order to bridge this gap. Third, results of this study found a high prevalence of dementia, delirium, and psychotic disorders in geriatric patients that have lacked MDC. Thus, psychologists that participate in MDC assessment of geriatric patients are recommended to appropriately assess for such disorders. Fourth, this study found that psychologists have a high degree of MDC knowledge regarding fluctuating course, difference between legal competency and capacity, and cognitive impairment and MDC. Fifth, this study found that psychologists report a high usage of cognitive screeners, but a low usage of MDC tools and instruments. Future research is indicated in order to investigate ways to improve the MDC tools and instruments to meet psychologists' clinical needs and better understand the role that cognitive screeners play in a MDC assessment. Sixth, this study found that participants valued the criteria in the widely accepted four-standard model of MDC. However, about half of the study's participants reported that it is important for a patient to make a treatment decision that is reasonable, which is not part of the four-standard model. Therefore, future research is recommended in order to better understand this finding. |
