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Testamentary capacity and delirium

Published online by Cambridge University Press:  01 July 2010

Benjamin Liptzin ,
Carmelle Peisah ,
Kenneth Shulman  and
Sanford Finkel
Benjamin Liptzin*
Affiliation:
Department of Psychiatry, Baystate Health, Springfield, MA, U.S.A.
Carmelle Peisah
Affiliation:
Academic Department for Old Age Psychiatry, Prince of Wales Hospital, and University of New South Wales, Sydney, Australia
Kenneth Shulman
Affiliation:
Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
Sanford Finkel
Affiliation:
University of Chicago Medical School, Wilmette, IL., U.S.A.
*
Correspondence should be addressed to: Benjamin Liptzin, Department of Psychiatry, Baystate Health, 759 Chestnut Street, Springfield, MA 01199, U.S.A. Phone: +1 413-794-4235; Fax: +1 413-794-4234. Email: benjamin.liptzin@bhs.org.
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Abstract

Background: With the aging of the population there will be a substantial transfer of wealth in the next 25 years. The presence of delirium can complicate the evaluation of an older person's testamentary capacity and susceptibility to undue influence but has not been well examined in the existing literature.

Methods: A subcommittee of the IPA Task Force on Testamentary Capacity and Undue Influence undertook to review how to assess prospectively and retrospectively testamentary capacity and susceptibility to undue influence in patients with delirium.

Results: The subcommittee identified questions that should be asked in cases where someone changes their will or estate plan towards the end of their life in the presence of delirium. These questions include: was there consistency in the patient's wishes over time? Were these wishes expressed during a “lucid interval” when the person was less confused? Were the patient's wishes clearly expressed in response to open-ended questions? Is there clear documentation of the patient's mental status at the time of the discussion?

Conclusions: This review with some case examples provides guidance on how to consider the question of testamentary capacity or susceptibility to undue influence in someone undergoing an episode of delirium.

Keywords

medical-legal issueswills
Type
Review Article
Information
International Psychogeriatrics , Volume 22 , Special Issue 6: Focus on training in psychogeriatrics , September 2010 , pp. 950 - 956
Copyright
Copyright © International Psychogeriatric Association 2010

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