Ensuring Your Wishes Are Heard: Understanding Testamentary Capacity Assessments in California

I have been doing capacity assessments for over a decade, and even after many years of experience, each case is unique, because people have many different life experiences that come into play in these complex evaluations. I find that most people, apart from attorneys working in this area, have questions about exactly what "testamentary capacity" is, and how a psychologist such as myself, might conduct this type of assessment. In this article, I will try to clarify some common misconceptions about testamentary capacity, which is a crucial aspect of estate planning in California. Let's start with an easy one: What is meant by "testamentary?” This is simply the capacity, or ability, to create a will that decides where a person's assets, whether financial or in the form of property and possessions, are going to go after that person has passed.

California Law and Testamentary Capacity

In California, Probate Code Section 6100 states that anyone 18 or older who is "of sound mind" can make a will. "Sound mind" translates to having testamentary capacity, and this can get very tricky in situations where there is a question of a person's cognitive function or ability to make decisions. Questions about a person's "sound mind" often come up in situations of severe mental illness, such as schizophrenia, or when a person's cognitive function is impaired because of a disease process, like dementia. Here, the law defines mental competency for creating a will as having the ability to:

1. Understand the nature of the testamentary act (making a will).

2. Understand and recollect the nature and situation of their property (this includes money, real estate, possessions, and any other assets).

3. Understand the natural objects of their bounty (who they might typically leave assets, like close relatives).

Legal terminology can be overwhelming for those others who are not legal professionals, but in this case, the law simply means that a person needs to understand what it is to make a well, what property or money they have to give away, and who they might leave their assets to after their death. In some cases, this is very straightforward, and there is no question of a person's ability to make a will, know what they have to give, and know who they want to give it to. But in other situations, testamentary capacity is not straightforward at all, for example, in the case of a person with dementia who cannot understand the meaning of making a will, or in the case of a person with schizophrenia who holds a delusional belief that a family member is plotting against them, and wishes to cut that person out of their will as a result of this delusion.

California-Specific Considerations

While the core evaluation process remains similar, here are some California-specific aspects to consider:

• Presumption of Capacity: California law presumes a person has testamentary capacity unless proven otherwise. This is very important because it is a matter of respect for individual autonomy. This is something that all of us want and expect–to make our own decisions about our lives, including what we want to happen to our assets after we die.

• Undue Influence: California courts take undue influence on the testator (person making the will) seriously. A capacity assessment, like the ones I conduct, will pay close attention to potential manipulation or coercion, especially if the will significantly deviates from what the person would typically do. For example, I have seen cases in which an older adult with a dementia diagnosis wishes to change their will to leave assets to a caregiver who has become intertwined in their life recently, despite concern and suspicion from family members who believe the caregiver is asserting undue influence over the person.

Finding Help in California

California has a vast network of qualified professionals to assist with testamentary capacity assessments, including myself. Typically, either a person wishing to establish or change their will, or a concerned family member, will reach out to me with a request for a capacity evaluation to determine whether the person has the capacity to make these changes. The evaluation involves testing and interviews with the person wishing to change their will, as well as collateral interviews with family members, caregivers, and others who may have insight into this situation and the person’s history and values. These evaluations also sometimes involve looking at financial records and medical records, which may provide valuable evidence about a person's capacity. For example, if financial records show that a person has been unable to pay their bills independently, or has given away thousands of dollars recently to scams, this may be evidence to understand the person's capacity to make it well. 

Estate planning attorneys can also guide you through this process, and I often get referrals from estate planning and attorneys for testamentary capacity evaluations in California.

Remember:

• A testamentary capacity assessment conducted by a qualified psychologist in Los Angeles and throughout California strengthens your will's validity.

• Don't hesitate to seek an evaluation, especially if pre-existing health conditions might raise concerns down the road. By planning ahead, you ensure your wishes are respected and your loved ones' inheritance is protected.

Begin a Testamentary Capacity Assessment in Los Angeles, CA

I would be happy to use my years of experience in conducting capacity assessments to help you find the right path forward. You can learn more about the benefits of testing with Dr. Reger by and more by following these simple steps:

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

2. Meet with Dr. Reger for an evaluation

3. Start evaluating testamentary capacity!

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

Capacity assessments are not the only service offered by my Redondo Beach-based practice. I’m also 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. Visit my blog for more help today!

A Brief Guide to Neuropsych Testing in Los Angeles

A psychologist specializes in assessment, including neuropsychological assessments, I often get questions about neuropsychological evaluations, what they involve, with the offer, and why they cost so much! Here is some information that may help.

What is Neuropsych Testing?

Neuropsych testing isn't a single test, but a comprehensive evaluation that assesses several different areas of brain function. In Los Angeles, these assessments are particularly helpful for:

• Diagnosing ADHD: Unraveling attention, focus, and impulsivity issues in children, adolescents, and adults.

• Learning Disorders: Identifying specific challenges like dyslexia or dysgraphia that can hinder academic performance.

• Memory Concerns: Exploring the nature and severity of memory problems, which could be due to various causes.

• Autism Spectrum Disorder (ASD): Evaluating cognitive and social functioning in individuals suspected of ASD.

• Impact of Brain Injury: Assessing cognitive changes after a concussion, stroke, or other brain injuries.

• Dementia Evaluation: Differentiating between normal age-related memory decline and early signs of dementia.

Because I work only with adults and not children, I most often do neuropsych testing with adults who are curious about an ADHD diagnosis, cognitive concerns related to a stroke, traumatic brain injury, multiple sclerosis, or another medical event, or cognitive decline related to dementia. I also do evaluations for people who suspect a diagnosis of autism, though it is important to note here that ASD is often diagnosed (in adults) without a neuropsychological evaluation. The same is true of ADHD. I find that neuropsych assessment is valuable in cases where a clear diagnosis cannot be made simply through a clinical interview, for example, done during a psychotherapy intake with a psychologist who can diagnose. So, although neuropsychological evaluation is not always necessary to receive a diagnosis of autism or ADHD, it can be helpful if there are many complex factors that make the diagnosis unclear.

The Neuropsych Testing Process in Los Angeles

The process typically involves several steps:

• Initial Consultation: Discussing your concerns and reasons for seeking testing.

• Clinical Interview: An in-depth conversation about your medical history, educational background, and any specific challenges you're facing.

• Standardized Testing: Administering a battery of tests that assess memory, attention, language, problem-solving, and other cognitive functions.

• Feedback Session: Review the results, explain the findings, and discuss potential diagnoses or recommendations.

One important note here is that all of this work requires many hours, both in the evaluation face-to-face with you, and also before and after the evaluation, selecting a tailored test battery, scoring and interpreting tests, writing up a report, and reviewing records, in some cases. People are sometimes surprised at the cost of a comprehensive neuropsychological evaluation, but there are typically between 10 and 20 hours of work put into each assessment, in addition to the expertise gained by many years of education, training, and experience. Hopefully, this helps explain the cost.

Who Conducts Neuropsych Testing in California?

Licensed psychologists with a Ph.D. or Psy.D. in psychology and specialized training in brain-behavior relationships, conduct these assessments. Here in California, a psychology license is a general license that covers every specialty, so there is no separate license for neuropsychologists, child psychologists, forensic psychologists, or any other specialty. The most important factor when it comes to finding the right psychologist for your evaluation is the doctor's competence in assessing what you need to be assessed.

For example, as a psychologist with a great deal of neuropsych testing experience in adults with dementia, medical complexity, and disability, I am well-qualified to do neuropsychological evaluations for adults with questions of cognitive function in the context of aging, traumatic brain injuries, medical events, and neurodiversity. Other neuropsychologists specialize in assessing children, so their areas of expertise may be in diagnosing learning disorders and determining accommodations for school settings. So, competence is important, in addition to the fit with what you need.

The Benefits of Neuropsych Testing

Neuropsych testing offers a wealth of benefits:

• Accurate Diagnosis: Provides a clear picture of your cognitive strengths and weaknesses, leading to a more accurate diagnosis.

• Informed Treatment Plan: Guides the development of personalized interventions and treatment strategies.

• Improved Academic Performance: Helps identify learning disabilities and pave the way for appropriate academic support.

• Enhanced Self-awareness: Provides valuable insights into how your brain functions, empowering you to manage challenges more effectively.

Finding the Right Neuropsychologist in California

With so many qualified professionals in California, and in Los Angeles, choosing the right psychologist is crucial. Consider factors such as their area of expertise, experience working with your specific concerns, and your comfort level when talking to them. Don't hesitate to ask questions and ensure you feel comfortable with the chosen professional.

Begin Neuropsych testing in Los Angeles, CA

Neuropsych testing is a powerful tool for understanding your brain and optimizing your cognitive health. It empowers you to find answers, make informed decisions, and pave the way for a brighter future. So, if you've been wondering about your cognitive abilities or have questions about a diagnosis, consider scheduling a consultation with a qualified neuropsychologist in California. Dr. Reger is happy to offer support with a variety of assessments through neuropsych testing. Start the testing process by following these simple steps:

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

2. Meet with Dr. Reger for an evaluation

3. Get a better understanding of neurological issues!

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

Neuropsychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. I offer multiple psychological assessments as well. Other assessments include capacity assessments, 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. Visit my blog for more helpful support today!

Debunking the Myth: Can You Fail a Neuropsychological Evaluation?

As a psychologist who does neuropsychological evaluations (neuropsych evals, for short), I often encounter misconceptions about neuropsychological testing. One of the most common questions I hear is, "Can you fail a neuropsych eval?" The answer? No, in the traditional sense of getting a passing or failing grade, you cannot.

However, there are some nuances to understand. Let's delve deeper into the purpose and process of a neuro-psych eval to clear up this confusion.

What is a Neuropsychological Evaluation?

A neuro-psych eval is a comprehensive assessment of your cognitive functioning. It's like a detailed map of your brain's strengths and weaknesses across various areas of function, including:

• Attention and concentration: How well can you focus and sustain attention?

• Memory: How well do you encode, store, and retrieve information?

• Language: How effectively do you use language to communicate and understand?

• Learning: How well do you acquire new information and skills?

• Executive functioning: How well do you plan, organize, and problem-solve?

• Processing speed: How quickly can you process information?

The Neuropsychological evaluation typically involves a combination of:

• Clinical interview: Discussing your social, medical, and mental health history, symptoms, and everyday challenges.

• Standardized cognitive testing: Administering specific tests designed to assess different cognitive domains.

• Review of medical records: Understanding any relevant medical conditions that might impact your brain function.

Why Don't You "Fail" a Neuropsych Evaluation?

The primary goal of a neuro-psych evaluation isn't to judge your performance but to create a detailed picture of your cognitive profile. This information is crucial for:

• Diagnosis: Helping identify underlying neurological or psychological conditions that might be impacting your thinking and behavior.

• Treatment planning: Informing the development of treatment strategies to improve your cognitive skills or compensate for weaknesses.

• Monitoring progress: Assessing the effectiveness of treatment interventions.

• Eligibility determination: Providing evidence for eligibility for educational support services or disability programs.

There's no single "correct" answer on any test. Everyone performs differently based on factors like age, education, and cultural background. Your scores are compared to “norms,” which means a large number of scores from people that let us know what scores we should expect on a given test. These tests are often adjusted for age, education, and other factors, so that you are compared to others similar to you in important ways. That gives us the best sense of where your scores fall in comparison to what we expect from others in your same age group.

The Importance of Effort and Validity

While you can't fail, putting forth a genuine effort is essential. Neuro-psych evals often include effort testing to ensure the results accurately reflect your abilities. Effort measures are built into testing and might involve tests where inconsistent performance raises questions about whether you're trying your best.

If a neuropsychologist suspects you're not putting in good effort based on these measures, they might flag the results as "invalid." This could limit the usefulness of the evaluation, hindering accurate diagnosis and treatment planning. There are many reasons people might not put their best effort into testing, but if that’s the case, we cannot trust the test results actually measure what we were trying to measure, and it would not be ethical to make a diagnosis or plan treatment based on invalid results.

Here are some tips for approaching your neuropsych evaluation effectively:

• Get a good night's sleep beforehand.

• Eat a good breakfast the day of testing.

• Arrive well-rested and alert.

• Ask clarifying questions if you're unsure about instructions.

• Do your best on each test, even if you find it challenging.

• Be honest about your limitations.

What Happens After the Evaluation?

Following the evaluation, the psychologist will analyze all the collected data. This includes your interview responses, test scores, and medical records. They then create a comprehensive report summarizing your cognitive strengths and weaknesses, offering potential diagnoses, and recommending appropriate interventions.

Here are some possible outcomes:

• Normal cognitive functioning: The evaluation may not identify any significant cognitive deficits.

• Specific cognitive impairments: The report might identify specific areas of cognitive deficit that could benefit from targeted interventions.

• Learning disorder: The evaluation might support a diagnosis of a learning disorder, informing educational support plans.

• Neurological condition: The evaluation might point towards a neurological condition, prompting further medical investigation.

Remember, the neuro-psych eval is a collaborative process. Discussing the findings with the neuropsychologist and your doctor allows you to ask questions, clarify results, and understand the next steps.

Start A Neuropsychological Evaluation in Los Angeles, CA

A neuro-psych evals is a valuable tool for understanding how your brain works. They don't involve passing or failing but rather aim to create a comprehensive profile of your cognitive functioning. By approaching the evaluation with a genuine effort, you can contribute to a more accurate and helpful assessment that aids in diagnosis, treatment, and ultimately, improved well-being. Start the evaluation process with Dr. Reger by following these simple steps:

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

2. Meet with Dr. Reger for an evaluation

3. Get a better understanding of neurological issues!

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

Neuropsychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. I offer multiple psychological assessments as well. Other assessments include capacity assessments, 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. Visit my blog for more helpful support today!

Navigating the Journey: Tips from a Geropsychologist for Living Well After a Dementia Diagnosis

A diagnosis of dementia can be overwhelming, bringing a wave of emotions and uncertainty for both the person diagnosed and their loved ones.

Perhaps you have noticed problems for a while and spoken to a doctor, perhaps you suspect cognitive decline, or perhaps you have had neuropsychological testing and received a diagnosis of dementia. As a psychologist with a specialty in assessment of cognitive change and capacity in aging, I've witnessed firsthand the challenges and triumphs people face on this journey. While there's no cure for dementia, there are strategies to maintain quality of life, maximize independence, and create a supportive environment.

Here are some key tips to navigate this path:

1. Educate Yourself:

Knowledge is power. Familiarize yourself with the specific type of dementia diagnosed. It’s always a good idea to talk to your doctor or psychologist, if you have one. Resources like the Alzheimer's Association, the National Institute on Aging, and dementia-specific support groups can provide valuable information about its progression, available treatments, and ways people cope. It’s also important to remember that there are many types of dementia, and while they all come with difficulties, they also have unique features that are important to understand so you can navigate your situation. For example, some dementias can involve personality changes or symptoms like hallucinations. These types of symptoms can be very confusing and scary, so preparing yourself and your family for these types of possibilities can make it easier to understand what’s going on.

2. Consider Neuropsych Testing:

If you haven’t had neuropsychological evaluation as part of your dementia diagnosis, it is worth considering, especially if you are in the early stages of cognitive change. This testing can give you, your loved ones, and your medical providers information about your strengths and areas where you need more support, as well as recommendations for ways to manage going forward based on your cognitive profile. 

3. Embrace Open Communication:

An open and honest dialogue is crucial. Discuss the diagnosis with your loved ones, including your wishes and concerns regarding care and decision-making. Talk to your doctor about treatment options, potential side effects, and future planning. Communication empowers everyone involved to navigate the journey together.

4. Prioritize Brain Health:

Just because you have dementia doesn't mean your brain can't be stimulated, or that you should give up trying to maintain your brain health. Engage in activities that keep your mind active, such as reading, puzzles, playing games, or learning a new skill. 

5. Maintain Physical Activity:

Regular exercise is vital for both physical and cognitive health. Aim for moderate-intensity exercise most days of the week. Try to keep the mindset that any movement that you enjoy is good for you; exercise should not be a punishment! Walking, swimming, dancing, biking on a stationary or hand bike, tai chi, or gentle/chair yoga are excellent options. Exercise can be adapted to any level of physical ability, and if you need help finding adaptive exercises, you can search online or find a disability-knowledgeable trainer, a kineosiotherapist, or a disability-friendly gym to support your physical activity. Exercise promotes blood flow to the brain, which can help maintain cognitive function. This is the number one most important thing any of us can do to preserve brain health over our lifetimes!

6. Structure and Routine are Key:

Create a consistent daily routine that provides structure and predictability. This can include regular mealtimes, sleep schedules, and established times for medications and activities. I have worked with many folks with dementia who are able to maintain independence well into the illness because they have a routine and don’t have to adapt to new circumstances. Change is harder on a vulnerable brain, so structure and routines can also reduce distress when dealing with dementia.

7. Maximize Independence While Balancing Safety:

As much as possible, maintain independence. Break down tasks into smaller, manageable steps and ask for assistance and support as needed. For example, perhaps managing money has become too overwhelming and you’ve been late on a few bills; asking an adult child you trust to become a joint signer on your bank account might allow them to set up auto pay for bills and help you when you need it, but still give you independence in accessing your own funds. It’s also important to be honest with yourself and your family if you realize there are ways you can’t be independent anymore. For example, driving is a tough one for most people to give up, especially in Los Angeles, where we are so dependent on our cars. But if you’ve got a diagnosis of dementia, or you’ve had a few fender benders or “close calls” while driving lately, it’s likely time to come up with an alternate plan and let go of the keys.

8. Adapt the Environment:

Make your environment dementia-friendly. Install safety features like grab bars in bathrooms, bright lighting, and clear walkways. Label cabinets and drawers for easy organization. Remove clutter that might cause confusion. Again, asking for help here is a good idea, as organizing your space can be overwhelming.

9. Focus on Strengths:

While dementia forces us to acknowledge cognitive limitations, celebrate your strengths and abilities as well. Use your existing skills and interests to engage in things you enjoy, or to adapt new ways of doing things you used to enjoy. This fosters a sense of accomplishment and boosts self-esteem.

10. Engage in Social Activities:

Stay connected to loved ones and participate in social activities. Social interaction helps maintain cognitive function and provides a sense of belonging. Explore volunteer opportunities, attend social events, call friends and family, or engage in hobbies that bring joy.

11. Seek Professional Support:

Don't hesitate to seek professional help from psychologists, therapists, or social workers. They can provide emotional support, guidance on coping strategies, and help manage behavioral changes associated with dementia. This is an incredibly difficult diagnosis that most of us are afraid of; there is no shame in talking to a professional about grieving and coping.

12. Join a Support Group:

Connecting with others facing similar challenges can be empowering. Support groups offer a safe space to share experiences, learn from each other, and find emotional support. These can be great for people with dementia in the early stages, and also for family members and caregivers.

13. Plan Ahead:

Sometimes when we are faced with news of a life-altering diagnosis, our initial reaction is to avoid thinking about it. It’s understandable to experience shock, grief, and even denial. But it’s crucial to discuss the diagnosis and prognosis with loved ones so that you can plan together for the future.

Begin Therapy for Older Adults in Los Angeles, CA

The more you express your wishes and make arrangements now, the easier things will be down the road for you and your loved ones. You deserve to have the best support structures when facing potential changes like this, and Dr. Reger is happy to help offer support with services like dementia testing. You can start your therapy journey by following these simple steps:

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

2. Meet with a Los Angeles Psychologist

3. Start receiving the support you deserve!

OFFERED BY DR. REGER IN LOS ANGELES, CA

Support for older adults and dementia testing aren’t the only services I offer. I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include pre-surgical assessments and med-legal evaluations. In addition to evaluations, I also provide capacity assessments, individual therapy, and mental health consultations and presentations. Visit my blog for more helpful support today!