Abstract

Aim: To identify in an Australian setting the characteristics of patients being referred to geriatricians for capacity assessments. Background: Geriatricians are being more frequently asked to assess patient's decision‐making capacity given our ageing population. Past research shows that dementia is a risk factor for impaired capacity in older persons. Methods: A retrospective chart audit was undertaken of 98 consecutive medical inpatients referred for capacity assessments between February 2015 and August 2017 in an outer‐metropolitan hospital. Statistical description and univariate analysis was completed on the data collected. Results: A prolonged length of stay and a diagnosis of dementia were statistically significantly related to a patient being found to lack decision‐making capacity (both p < .001). The patient population reviewed had cognitive impairment and markers of social isolation with 56% having a diagnosis of dementia, 70% not presently married, and 63% not having any existing community services. There were 37 (38%) new diagnosis of dementia made during the geriatrician's assessments. The capacity question to be addressed for 90% of patients was their ability to return home on discharge. Most patients who were found to lack capacity were discharged to a residential aged care facility (54%), whilst most who retained capacity were discharged home (73%). Conclusions: Better understanding this patient group enables health care professionals to be more mindful of those who may benefit from comprehensive geriatric assessment to optimise their medical and social factors. Future research could build on our work by comparing this group to a case‐matched control group.

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