My Parent Won’t Take a Capacity Assessment, What Do I Do?

If you have concerns about your older parent’s decision-making, ability to manage their own finances, or ability to live independently, chances are you have considered asking them to have a capacity assessment by a psychologist in California.  Sometimes, these types of requests are met with a lot of resistance.  Here’s some information that might help.

What Is a Capacity Assessment?

A capacity assessment is the process of determining whether an older adult has the ability to make their own decisions about their life. This can be important in a number of situations, such as when an older adult is considering making a change to their living arrangements, making medical decisions, or managing their finances.  

There are a number of different factors that can be considered in a capacity assessment, including older adults:

• Cognitive abilities, such as their ability to understand information, retain information, and make decisions

• Emotional abilities, such as their ability to manage their emotions and make rational decisions

• Physical abilities, such as their ability to communicate and interact with others

• Life experiences and values

The Goal of Capacity Assessment

Age alone, or even a diagnosis of dementia, does not automatically mean a person lacks capacity.  My goal in capacity assessment is always to preserve a person’s autonomy and ability to make their own decisions to the extent possible while also ensuring their safety and well-being. This is a balancing act, but the goal is NOT to automatically take away decision-making rights just because a person is older or has a dementia diagnosis.

The specific factors that are considered in an assessment will vary depending on the situation, and the concern. For example, if an older adult is considering making a change to their living arrangements, the assessment may focus on their cognitive abilities, practical safety skills, and their ability to manage their finances. If an older adult is deciding on a risky medical procedure, the assessment may focus on their understanding of the medical information and ability to make an informed decision.

The results of a capacity assessment can have a big impact on an older adult's life. If the psychologist determines that the older adult lacks capacity in an area, they may be unable to make their own decisions about their life in that area. In this case, a guardian or conservator may be appointed to make decisions on their behalf.

Explain Why You Want a Capacity Assessment With a Psychologist

Obviously, the results of a capacity assessment can have a big impact on your parent’s life, and it is understandable that they might be resistant to testing.

If you want your older adult parent to do a capacity assessment with a psychologist because you are concerned about their safety or decision-making, here are some thoughts on how to encourage their participation.

• Talk to your parent about your concerns at a calm moment when you have time and privacy to talk.

• Explain why you think they should take a capacity assessment and what you hope to achieve by doing so.  Be specific about what worries you, and give concrete examples.

• Be respectful and understanding, but also be clear in your belief that it is in their best interest.

• Reassure them that you will help and support them as best you can no matter what.

If They Still Decline a Capacity Assessment, Then What?

You cannot force your parent to take a capacity assessment. However, you can take steps to help protect your parent's interests.

• Gather evidence of your parent's declining mental capacity. This could include things like medical records, reports from doctors or other healthcare professionals, or even just observations of your parent's behavior. For example, if your parent has been the victim of a financial scam, document when and details of what happened, how much money they lost, and so on. This evidence will help to support your case if you need to take legal action.

• Consult with an attorney. An attorney can help you understand the legal options available to you and can represent you in court if necessary.

• Consider a consultation with a psychologist with expertise in capacity assessment, like Dr. Reger, who can offer her insight into your specific situation, and can explain the process of assessment.

• Reach out to a support group or advocacy organization. There are many organizations that can provide support and guidance to families dealing with issues of mental capacity. They can offer advice on how to talk to your parent, how to gather evidence, and how to navigate the legal system.

Here are some additional resources that you may find helpful:

• The National Council on Aging: https://www.ncoa.org/

• The Alzheimer's Association: https://www.alz.org/

• The American Bar Association: https://www.americanbar.org/

Receive a Capacity Assessment in Los Angeles, CA

If your loved one decides to receive support in the form of a capacity assessment, Dr. Reger would be honored to help. She provides capacity assessments at several locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for your capacity assessment

3. Start receiving the support your loved one deserves

OTHER COUNSELING SERVICES OFFERED BY DR. REGER IN LOS ANGELES, CA

I know that you or your family can encounter more than one mental health concern at a time. This is why I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations.

Understanding the Science Behind Neuropsych Testing in Los Angeles, CA

Psychologists go to school for many years to learn how to administer and interpret neuropsych and other psychological evaluations.  Here’s a bit of background information to help non-psychologists understand the science behind a neuropsych assessment.

What Is Neuropsych Testing?

Neuropsychological testing is a scientific method of evaluating someone’s brain and behavioral functioning. It can help understand the impact of brain injury (like a TBI), medical problems (like a stroke or chemotherapy), or mental health concerns (like depression or ADHD) on a person's ability to think, learn, remember, and do everyday tasks.

The Science Behind Neuropsych Testing

The science behind neuropsych testing is based on the understanding that different areas of the brain are responsible for different cognitive functions. For example:

• Frontal lobes are responsible for executive functions such as planning, organizing, and problem-solving. 

• Temporal lobes are responsible for language processing

• Parietal lobes are responsible for spatial processing

These brain area/brain function connections have been studied for many decades by psychologists and neuroscientists, and researchers are constantly learning new information about how our brains work. 

What Can Neuropsych Tests Measure?

Neuropsychological tests are designed to measure specific brain functions. For example, there are common tests that measure:

• Attention

• Memory

• Processing speed

• Language

• Visual and spatial skills

• Executive functions

A comprehensive neuropsychological evaluation will include tests that measure these areas, and possibly more. The exact tests a psychologist chooses will depend on the question being asked.  

For example, I would choose one test battery to assess for dementia, and another to assess for ADHD.  In any case, a comprehensive approach is best, rather than going in with an assumption about what’s going on, and testing only that area. If we suspect a person has the beginnings of dementia and only test memory, we might miss other important information that would help with a specific diagnosis. Or, if we only test attention in ADHD, we could miss a learning disability or other problem that is causing difficulty with attention or behavior. Neuropsych testing is as much an art as a science in many ways, which is why it’s important to choose a psychologist with expertise in the issue you want to know about.

How Neuropsych Testing Is Interpreted

The results of neuropsychological testing are interpreted by a neuropsychologist or a psychologist with expertise in neuropsychology. The psychologist will compare the person's test scores to norms for people of the same age, education, and gender. Norms are average scores of a large group of people who have taken a test. This allows us to identify areas of cognitive weakness or impairment, in comparison to what is expected for someone of the same age and education level.

The Benefits of Neuropsych Testing

Neuropsychological testing can be used to diagnose a variety of brain-related disorders, including Alzheimer's disease, dementia, traumatic brain injury, learning disorders, ADHD, and autism. It can also be used to assess the effects of a brain injury or disease on a person's ability to function in everyday life.

Neuropsych testing can help:

• Identify brain problems that may not be apparent from a physical exam or medical history.

• Diagnose brain-related disorders.

• Assess the severity of a brain injury or disease.

• Plan treatment and rehabilitation.

• Monitor the progress of a brain injury or disease over time.

Begin Neuropsych Testing in Los Angeles, CA

Overall, neuropsych testing is a valuable and science-based tool for assessing the cognitive and behavioral functioning of people with concerns related to brain function. Dr. Reger provides psychological assessments at multiple locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for psychological testing

3. Gain a better understanding of yourself!

OTHER SERVICES OFFERED WITH DR. REGER IN LOS ANGELES, CA

I am happy to offer psych evaluations and a variety of other assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. I also provide mental health services including individual therapy, counseling for older adults, and mental health consultations and presentations.

Understanding Financial Abuse and the Role of Psychologists in Prevention

Unfortunately, older adults and disabled or dependent adults are at risk of financial abuse. 

Financial abuse happens when someone exploits another person’s financial resources for personal gain, causing harm or distress.  This can happen in many different ways and often happens when a family member or caregiver misuses or takes money that belongs to someone they’re supposed to help care for.  Older adults can also be vulnerable to scams that trick them into giving their money to a stranger.  Victims often feel ashamed or fear retaliation, making it challenging to detect and address financial abuse. Psychologists play a crucial role in recognizing and addressing financial abuse through capacity testing and assessing for undue influence.

Capacity or Undue Influence Assessment With a Psychologist

Psychologists conduct capacity testing to evaluate an older adult's ability to make informed decisions regarding their finances. Using standardized assessments and interviews, psychologists assess cognitive functioning, memory, judgment, and understanding of financial matters. This evaluation helps determine whether the individual has the capacity to manage their financial affairs independently. Identifying cognitive impairments or vulnerabilities can aid in safeguarding vulnerable older adults from financial exploitation.

Undue influence happens when someone manipulates an older adult to influence their decision-making related to finances, property, a will, or other resources. Psychologists play a vital role in assessing for signs of undue influence by examining the dynamics between the older adult and those around them. They look for signs of control, isolation, intimidation, or dependency. By assessing the presence of undue influence, psychologists can identify cases where an older adult's decisions may not be entirely voluntary or in their best interest.

Capacity testing and assessing for undue influence are crucial steps in protecting older adults from financial abuse. These evaluations:

1. Identify Cognitive Changes:

Capacity testing includes an evaluation of cognitive function, so it can detect any decline that may impact a person’s financial decision-making. Recognizing cognitive impairments helps determine the appropriate level of support someone needs to manage and protect their finances.

2. Preserve Autonomy:

Capacity testing provides information about a person’s ability to make sound financial decisions independently. It helps protect their autonomy, ensuring they have control over their finances and are not subjected to undue influence.  If someone has problems with financial capacity, a psychologist can also offer recommendations about what supports would allow them to maintain as much independence as possible.  For example, if someone is having trouble paying bills on time because of a memory problem, something as simple as setting up autopay could give them the support they need, and allow them to remain in control of their finances with help from a trusted family member.

3. Uncover Manipulation:

When there is a question of undue influence, testing with a psychologist can shed light on situations where a vulnerable older adult may be under the control of others. This helps protect older adults from exploitation by recognizing signs of emotional manipulation, isolation, or threats.

4. Provide Intervention and Support:

Psychologists offer interventions such as therapy or referrals to appropriate legal and social services to address the impact of financial abuse.  In California, Adult Protective Services investigates financial abuse, and each county has its own APS program.  Anyone can make a report to APS if financial abuse is suspected.

WARNING SIGNS FOR FINANCIAL ABUSE: WHEN A PSYCHOLOGICAL EVALUATION MAY BE HELPFUL

It can be tough to spot financial abuse because victims often feel embarrassed or scared to ask for help. However, there are some signs that might suggest that someone is being financially abused:

• Suddenly having money problems, like not being able to pay bills or strange activity in bank accounts.

• Major changes in important documents like wills or power of attorney, especially when another person is encouraging these changes.

• Feeling isolated or controlled by a caregiver or family member.

• Losing valuable things without any good explanation.

• Unusual purchases or money transactions that don't make sense.

Begin A Capacity Assessment In Los Angeles, CA

If you have concerns about an older adult in your life, or if you are an older adult and worry you may be in a financially abusive situation, a capacity or undue influence assessment may help bring clarity to the situation and stop further abuse. Dr. Reger is equipped to offer testing and assessment services across California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for a capacity assessment

3. Start receiving protection from financial abuse!

OTHER SERVICES OFFERED WITH DR. REGER IN LOS ANGELES, CA

I am happy to offer capacity testing and a variety of other assessments. Other assessments include psych evaluations, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. I also provide mental health services including individual therapy, counseling for older adults, and mental health consultations and presentations.

How to Make the Most of a Psych Eval, Part II: Testing Day

A psychodiagnostic or neuropsychological evaluation is an investment of time and money, and if you are seeking a psych eval, you want to make the most of your investment.  In this series, I’ll share some tips for how to do that.

How to Prepare Before Your Neuropsych Testing Day

Testing makes a lot of folks nervous.  That is totally normal.  Even if you are worried about testing, there are a few things you can do before your testing day to make things as easy on yourself as possible.

• Clear your schedule on testing day.  You don’t want to be rushing from something else to testing, or worrying about when you will finish.  Get someone to cover for your usual responsibilities (like school drop off, cooking dinner, etc) and take the day off of work.

• Plan ahead for food.  No one thinks clearly when they’re hungry!  Bring water, small snacks, and a packed lunch, or check out the area near the office ahead of time and figure out a place for a very quick bite at lunch time.  Testing lunch breaks are usually short, because there is a lot to get through.

• Bring anything you need to hear, see, write, or get around.  Testing can involve writing, reading, and listening, so bring glasses, hearing aids, and any other adaptive equipment you use regularly.

• Take any usual medications.  If you take prescribed medications daily, or as needed, take whatever you would normally take on the day of testing.  The exception would be anything that makes you drowsy or clouds your thinking (e.g., a pain medication you rarely take).

• Don’t use substances or alcohol in the days before testing.  Avoid any substances that could impact your thinking, and consequently, your test results.  Don’t use cannabis or alcohol, or other recreational drugs, before testing.  In a perfect world, you would avoid cannabis for at least one month before testing, and alcohol for at least one day.

• Get a good night’s sleep.  Do your best to get to bed early and rest, because that will help you give your best on testing.

What to Expect on Neuropsych Testing Day

People often show up for testing very unsure what they are in for.  Here are some general ideas of what to expect from psych testing.

• A lengthy interview.  Psychologists need information about your personal history, including your social history, medical history, mental health history, educational background, and work history.  This helps us understand whether any of these factors play a role in the symptoms you’re experiencing.

• Paper and pencil testing.  Some testing requires you to write or draw on paper.

• Computer or tablet testing.  Some tests are automated or presented digitally or require you to do a task on a computer.

• A few short breaks.  Typically, the evaluator will offer breaks when there is a good point in testing (meaning, the break won’t interfere with any timed tasks or memory tasks).  You are also welcome to ask for a break if you need one!

• No immediate results.  This is tough for folks, especially after a long day of testing, when you really just want to know the results.  But scoring, interpreting, and writing up a report from testing takes quite a lot of time. In fact, for many types of reports, the time spent working on things apart from the patient is actually more than the hours spent with the patient in direct testing.  So, you will need your patience.

What to Expect After Neuropsych Testing

After testing, here’s what to expect.

• A few weeks of waiting.  It takes usually anywhere from two to six weeks for the testing report.  As I mentioned above, there is a lot of work that goes into the process after your part of the testing is complete, and this takes time.

• A feedback session. After your report is done, you’ll meet with your psychologist to discuss the testing results.  This is usually a half hour or less, and gives you the opportunity to ask questions about your results, diagnosis, recommendations, and anything else in the report.

• Recommendations.  You probably sought testing because you wanted to insight and guidance about where to go next.  The recommendations in your psychological eval report are tailored to you, and you should read them carefully and follow up on each one.  This is how you get the most value out of your investment in testing.

• A copy of your report for your own use.  Your psychologist will give you a paper or digital copy of your testing report.  Treat these like gold, especially if you are using them for accommodations at school or work.  Regardless, you may need or want the report in the future, for example, if you have cognitive changes for any reason, a previous report can serve as a baseline.  It is always a good idea to save your report so you can access it if you ever need it again.

Neuropsychological testing is a big investment of time, money, and effort.  These are some ways you can make the most of a psych eval!

Begin A Neuropsychological Assessment in los angeles, ca

Psychological testing can sound like a trying experience, but the benefits are very much worth the work. Dr. Reger provides psychological assessments at multiple locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for psychological testing

3. Gain a better understanding of yourself!

Other Services Offered with Dr. Reger in Los Angeles, CA

I am happy to offer psych evaluations and a variety of other assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. I also provide mental health services including individual therapy, counseling for older adults, and mental health consultations and presentations.