Details

Autor(en) / Beteiligte

• Reimers, Karen,

Titel

The clinician's guide to geriatric forensic evaluations

Ort / Verlag

London, United Kingdom : Academic Press, an imprint of Elsevier,

Erscheinungsjahr

[2019]

Beschreibungen/Notizen

• Front Cover -- THE CLINICIAN'S GUIDE TO GERIATRIC FORENSIC EVALUATIONS -- THE CLINICIAN'S GUIDE TO GERIATRIC FORENSIC EVALUATIONS -- Copyright -- Dedication -- Contents -- Preface -- Objectives of this book -- Chapter-by-chapter summary -- Conclusion -- REFERENCES -- Acknowledgments -- Disclaimer -- One - Introduction to geriatric forensic evaluations -- Who are older adults? -- Ageism and older adults -- What are forensic evaluations? -- Forensic interviewing -- Who performs geriatric forensic evaluations? -- Multidisciplinary team -- Existing guidelines for geriatric forensic evaluations -- Types of geriatric forensic evaluations -- Criminal geriatric forensic evaluations -- Adjudicative process -- Malingering/feigning -- Civil geriatric forensic evaluations -- Contemporaneous geriatric forensic evaluations -- Retrospective geriatric forensic evaluations -- How do geriatric forensic evaluations differ from forensic evaluations in younger people? -- General Considerations -- Mechanics of the evaluation -- Addressing sensory input deficits -- Communication techniques -- Should you video record the evaluation? -- Potentially reversible issues: medical, affective, social-context -- Role of collateral information -- Physical aging, medical problems, and frailty -- Medications and polypharmacy -- The 3 Ds: depression, delirium, dementia -- Psychiatric conditions in older adults -- Other psychiatric conditions in older adults -- Depression -- Other psychiatric conditions in older adults -- Psychosis -- Intellectual disability -- Bipolar disorders -- Anxiety disorders -- Obsessive-compulsive disorders -- Post-traumatic stress disorder -- Hoarding -- Substance use disorders -- Mental status examination in older adults -- Appearance and behavior -- Alertness versus wakefulness -- Speech and language -- Mood -- Thought content and process.
• Sensory input and perception -- Lethality assessment -- Cognition -- Attention -- Need for multiple assessments -- Conclusion -- Selected references -- Two - Ethical and legal issues -- Ethics in dementia -- Professional guidelines -- Ethics in forensic evaluations -- Ethical values to consider -- Professional competence -- Forensic versus therapeutic role -- Importance of self-care -- Integrity and impartiality -- Multiple relationships/conflicts of interest -- Avoid taking requests directly from litigants -- Working with attorneys -- Fees and financial relationships -- Legal issues -- Geriatric criminal evaluations -- Dementia and crime -- Sociopathy in older adults -- Malingering/feigning -- Adjudicative process -- Competency to stand trial -- Restoration of competency to stand trial in older adults -- Insanity defense -- Evaluation criteria for insanity defense -- Presentencing evaluations -- Older offenders in correctional settings -- Selected references -- Three - Evaluation of cognitive impairment -- Cognitive changes in older adults -- Normal aging -- Changes in executive functioning -- Importance of decision-making abilities -- Mild cognitive impairment (MCI) -- What is dementia? -- How common is dementia? -- Symptoms of dementia -- Challenges in diagnosis -- Different systems for diagnosing dementia -- Multidisciplinary treatment of dementia -- Neurobehavioral /neuropsychiatric symptoms of dementia -- Neuropsychiatric symptoms of dementia: -- Amnesia -- Apathy -- Agnosias -- Aphasia -- Apraxia -- DSM-5 neurocognitive disorders -- General diagnostic criteria -- Cognitive domains -- Psychometric definitions -- Etiological subtypes of NCDs -- Major and mild neurocognitive disorders -- Major neurocognitive disorder -- Mild neurocognitive disorder -- Delirium -- Tips for diagnosing dementia and DSM-5 NCDs -- Interviewing strategies.
• Differential diagnosis of dementias -- Dementia is a clinical diagnosis -- Diagnostic tests for dementia and role of neuroimaging/biomarkers -- Diagnosing DSM-5 neurocognitive disorders -- Note unwieldy use of adjective "mild" -- Algorithms for DSM-5 NCD diagnosis -- Cognitive screening in older adults -- Selecting a cognitive screening test -- Selected instruments -- Calculation, verbal fluency, naming -- Clock drawing test (CDT) -- Mini-Cog -- MoCA -- MMSE -- SLUMS -- Trail making tests A and B -- CDR -- EXIT -- FAB -- Global deterioration scale -- Strengths and drawbacks of selected screening tests -- Test norms for older adults -- When to refer to a neuropsychologist -- Conclusion -- Selected references -- Four - Evaluation of decision-making capacity and guardianship -- Principles of capacity assessment -- Framework for capacity assessment -- Functional capacity -- Definition of capacity/competence -- Presume capacity until proven otherwise -- Capacity is task-specific and domain-specific -- Principle of proportionality -- A collaborative approach -- Personal values and emotional factors in decision making -- Ageism and myths about decision-making capacity -- Types of decision-making capacity -- Capacity to make medical decisions -- Advance directives -- Capacity to appoint a health care proxy -- Capacity to consent to research -- Capacity to live independently -- Driving -- Capacity to work, fitness for duty evaluations -- Capacity to vote -- Sexual consent -- Marriage -- Financial decisions -- Testamentary capacity -- Banks versus Goodfellow criteria -- Contemporaneous evaluation -- Retrospective evaluation -- Capacity to make end of life decisions -- Supported and surrogate decision-making -- Guardianship and conservatorship -- Evaluating guardianship candidates -- Guardianship reform -- Conclusion -- Selected references.
• Five - Evaluation of elder abuse and financial exploitation -- Elder abuse -- Risk factors for elder abuse -- Definition -- Types of elder abuse -- Clinical evaluation of elder abuse -- Interviewing techniques for elder abuse -- Clinical tips: legal and ethical issues in elder abuse cases -- Documentation and reporting -- Elder financial exploitation -- Undue influence -- Contemporaneous evaluation of undue influence -- Retrospective evaluation of undue influence -- Conclusion -- Selected references -- Six - Geriatric forensic report writing and testimony -- Ethical considerations for forensic reports -- Geriatric forensic report writing -- Workflow -- Best practices -- Only write a report if retaining counsel requests it -- Follow a usual routine or protocol -- Identify the legal issue and any relevant legal standards -- Write in a clear style -- Style guidance -- Avoiding hedge words -- Editing and proofreading -- The final product -- Organize the report -- Know the specific facts of the case -- Offer opinions only if supported by data -- Problems and pitfalls -- Acting like an attorney -- Confusing clinical and forensic reports -- Equating dementia with lack of capacity -- Addressing the wrong forensic issue -- Getting distracted by family dynamics -- Relying on unsubstantiated diagnoses and inaccurate data -- Disregarding data that conflicts with opinion -- Misapplying psychological testing -- Ignoring the dynamic nature of capacity -- Destroying records too soon -- Geriatric forensic testimony -- Best practices -- Be aware of deposition and trial dates -- Prepare with retaining counsel -- Tell the truth -- Speak clearly and simply -- Look credible and professional -- Problems and pitfalls -- Being a professor, not a teacher -- Anger and defensiveness -- Awkwardness about fees -- Skeletons in the closet -- The "primrose path" and other traps.
• Not a memory test -- Rambling -- Conclusion -- Selected references -- 1 - Afterword -- Growing need for evaluators -- Emerging areas of research, future directions of the field -- Needs of older offenders -- Criminalization of elder abuse -- Improving work with multidisciplinary teams -- Cultural issues -- Risk management -- Adapting techniques from child forensic interviewing -- Medicare billing, documentation and coding -- Psychopharmacology, black box issues -- Psychiatric home care and telemental health -- Long term care issues -- Suicide -- Consumer protection -- Restoration of rights in guardianship -- Elder courts -- Collaboration with elder law attorneys -- Residency and fellowship training -- Future needs -- Conclusion -- Selected references -- 2 - Sample psychiatric report -- Executive summary -- Background -- Key events in Mrs. Jones' life -- Tornado -- New will -- Signing the new will -- Questions to address -- Qualifications -- Documents reviewed -- Methodology -- Findings -- Four causes of impaired mental ability to make a will and susceptibility to undue influence -- Dementia -- Brief Interview of Mental Status (BIMS) -- Scores on BIMS indicate progressive cognitive decline -- Impaired executive function -- Medical illness and frailty -- Mrs. Jones' 26 medical diagnoses -- Mrs. Jones met frailty syndrome criteria36 -- Polypharmacy (multiple medications) -- Mrs. Jones' 23 medications37 -- Side effects of medications -- Beers criteria: high risk medications -- Mrs. Jones' medication changes, Jul-Sep 2014 -- Further changes to medications -- Psychiatric and emotional issues -- Psychiatric conditions -- Criteria for testamentary capacity -- Knows a will is being made -- Knows the kind and extent of her property -- Can identify and remember those persons she would naturally give her property to.
• Knows how she wants to distribute her property.
• Description based on print version record.