Cognitive Competence and Decision-making Capacity

Abstract

INTRODUCTION|This essay is based upon a panel discussion at the 2020 Creighton Law Review Symposium and Tepoel Lecture entitled The 21st Century Trust: Evolution, Innovation, Adaptation. As the population of the United States shifts, resulting in a larger proportion of individuals living to age 65 and older, ensuring that these individuals are supported in terms of maintaining their decision-making independence when appropriate, is essential. There are normative age-related changes in both cognitive and physical functioning with age, but the impact on an individual’s decision-making is often nonexistent, minimal, or temporary. This essay includes information on normative age-related changes in cognition and the relation to capacity and competency. In addition, appropriate considerations for decisional capacity and evaluation of capacity are discussed, along with suggestions to support aging clients.