Decision-making, cognition, and aphasia: developing a foundation for future discussions and inquiry

Suleman, Salima; Kim, Esther

doi:10.1080/02687038.2015.1049584

Cited by 23 publications

(24 citation statements)

References 68 publications

(112 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While Jayes et al () reported that the choice of which MDT members assess capacity may often be decided on perceptions of professional hierarchy and responsibility, it should be guided on the basis of which HCP has more knowledge, skill or information about the decision and the patient. For example, speech and language pathologists have emphasised their specialist skills and their role for people with communication difficulties like aphasia (Aldhous et al, ; McCormick et al, ; Suleman & Kim, ). Therefore, it is not surprising in this study that occupational therapists reported significant involvement in DMC assessment regarding independent living, and less so in other areas, such as sexual consent.…”

Section: Discussionmentioning

confidence: 99%

Occupational therapy and decision‐making capacity assessment: A survey of practice in Ireland

Usher

Stapleton

2019

Aus Occup Therapy J

View full text Add to dashboard Cite

Introduction The aim of the study was to explore occupational therapy practices regarding decision‐making capacity assessment and to examine factors that impact on engagement in this area. Methods Occupational therapists in Ireland were invited to participate in a cross‐sectional online questionnaire. Results One hundred and seventy‐two occupational therapists responded. 65.77% (n = 98) reported that occupational therapy plays an important role in capacity assessment in their workplace. Occupational therapists most frequently contributed to decision‐making capacity assessment for independent living (79.19%, n = 118), driving (45.89%, n = 67) and financial management (44.44%, n = 64). Many participants reported that this is more difficult than other aspects of practice and that they are not satisfied with decision‐making capacity assessment procedures in their workplace. A large majority (91.86%, n = 113) reported occupational therapists would benefit from additional training and practice guidelines in the area of decision‐making capacity assessment. Conclusion The study confirms that occupational therapists have a role to play in the multi‐disciplinary assessment of decision‐making capacity. The results of the survey suggest that decision‐making capacity assessment is complex and challenging. Factors such as confidence, education and training impact on engagement with this area of practice. There is a need to develop education resources and guidelines for occupational therapists.

show abstract

Section: Discussionmentioning

confidence: 99%

Occupational therapy and decision‐making capacity assessment: A survey of practice in Ireland

Usher

Stapleton

2019

Aus Occup Therapy J

View full text Add to dashboard Cite

show abstract

“…Both the language barrier that defines aphasia and any accompanying cognitive issues should be carefully evaluated and circumvented to the extent possible using appropriate communication supports. 21,22 THE PROCESS FOR ESTABLISHING CAPACITY TO MAKE LEGAL AND/ OR CLINICAL DECISIONS When exploring the issue of communication supports, it is important to understand the stages involved in the decision-making process. Zuscak et al 23 provide a three-step decision framework that explicitly includes communication support strategies, as follows: (1) understanding relevant information; (2) appreciating consequences and reasoning; and (3) communicating a choice.…”

Section: Misinterpretation Of the Term Cognitive Impairment In Relatimentioning

confidence: 99%

“…It also has been cited as a method that can be used to support attention and memory processes in a decision-making appraisal. 22 A signature feature of SCA TM is a technique for verifying that information provided by the person with apha-sia is what he/she intends to convey and that it has been understood by the partner. See Table 1 for examples of SCA TM applications, as well as additional communication support strategies that can compensate for both language and cognitive impairments during capacity assessments.…”

Section: Reading Comprehensionmentioning

confidence: 99%

Assumptions about Decision-Making Capacity and Aphasia: Ethical Implications and Impact

Kagan¹,

Shumway²,

MacDonald

2020

Semin Speech Lang

View full text Add to dashboard Cite

This article explores the issue of aphasia and decision-making within the context of clinical ethics and patient rights. The cases described illustrate the danger of making assumptions about the inherent competence of people with aphasia and the life-altering consequences if no attempt is made to “accommodate” or support communication when competence may be masked by aphasia. Speech-language pathologists have a moral obligation and a key role to play in providing communication support that may serve to reveal a person's intact capacity to make specific decisions, as well as in supporting the steps involved in the decision-making process. This role also extends to providing guidance, education, and training for others involved in evaluating the decision-making capacity of people with aphasia. Communication support strategies useful at each stage of the decision-making process are detailed.

show abstract

“…According to the dual‐process theory of decision making, for example, rational decision making in typical adults comprises two distinct processes: one is fast, automatic and unconscious (a Type One process) and the other is slow, deliberative and conscious (a Type Two process; Evans, ; Evans & Over, ; Evans & Stanovich, ). This theory highlights that a “Type Two” process is essential for a person to make rational decisions and involves the cognitive functions of working memory and executive function (Evans & Stanovich, ) as well as attention and language (Suleman & Kim, ). When applying this theoretical framework to mental capacity assessment, if a person were unable to engage a Type Two process, this would support a lack of mental capacity.…”

Section: Introductionmentioning

confidence: 99%

The predictive validity of the MoCA‐LD for assessing mental capacity in adults with intellectual disabilities

Edge

Ewing

2019

Research Intellect Disabil

View full text Add to dashboard Cite

Background Mental capacity assessments currently rely on subjective opinion. Researchers have yet to explore the association between key cognitive functions of rational decision making and mental capacity classifications for people with intellectual disabilities. Method Sixty‐three adults completed the Montreal Cognitive Assessment, which yielded estimates of their overall cognitive ability (MoCA‐LD) as well as their memory, attention, language and executive functioning. Differences in scores were explored for those who had, and lacked, capacity, and logistic regression was used to test the predictive validity of each measure. Results There were significant differences between both groups for all measures. Logistic regression identified MoCA‐LD as a significant predictor of capacity assessment outcomes. ROC curve analysis provided novel, evidence‐based benchmarks to help guide clinical practice based on MoCA‐LD scores. Conclusion This study offers a foundation for more objective approaches to mental capacity assessment. This demonstrates that assessments of cognitive ability can yield information that is helpful for mental capacity evaluations.

show abstract

Decision-making, cognition, and aphasia: developing a foundation for future discussions and inquiry

Cited by 23 publications

References 68 publications

Occupational therapy and decision‐making capacity assessment: A survey of practice in Ireland

Occupational therapy and decision‐making capacity assessment: A survey of practice in Ireland

Assumptions about Decision-Making Capacity and Aphasia: Ethical Implications and Impact

The predictive validity of the MoCA‐LD for assessing mental capacity in adults with intellectual disabilities

Contact Info

Product

Resources

About