Competence Assessment in Dementia

The increasing number of demented elderly in our societies, the ongoing debate on patient's rights and autonomy, and the growing body of knowledge on the dementias led the European Dementia Consensus Network (EDCON) to regard competence assessment in dementia as an important topic of debate. EDCON performed a transeuropean survey and has agreed on a consensus, which takes into account the variability of clinical symptoms of dementia as well as the special functions required for different purposes.

This book contains a summarized consensus as well as chapters on the state of art of neuropsychological functions and how they are related to the areas of competence. It features chapters that deal with ethical and legal perspectives as well as one that covers competence in the field of driving capacity. In addition, the book contains short contributions on the situation in individual European countries.

1 Dementia and related disorders affect the suffer- minimal standards of care for people with dementia , ers' ability to perform activities of daily living and the improvement of access to diagnosis and treat- 2 3 to make appropriate decisions about various issues ment , ethical issues related to research in dementia , relevant to their life. While there is no disagreement the problems related to severe dementia, stigma and about these facts there is little clarity and even less social exclusion of people with dementia, assessment consensus about the ways in which competence to of outcome of treatment of dementia and the asse- make decisions should be assessed in daily practice ment of competence of people with dementia. The - nor is there agreement about the levels of compe- work to develop consensus on the latter subject lead, tence at which it is in the best interest of the people inter alia to the production of this volume. with dementia to have a guardian and receive legal In its work the EDCON Steering committee - protection against abuse and other mistreatment. lects areas on which it will concentrate and desig- In daily clinical practice there is a large heterogene- nates a coordinator for the work on each of those.

The increasing number of demented elderly in our societies, the ongoing debate on patient's rights and autonomy, and the growing body of knowledge on the dementias led the European Dementia Consensus Network (EDCON) to regard competence assessment in dementia as an important topic of debate. EDCON performed a transeuropean survey and has agreed on a consensus, which takes into account the variability of clinical symptoms of dementia as well as the special functions required for different purposes.This book contains a summarized consensus as well as chapters on the state of art of neuropsychological functions and how they are related to the areas of competence. It features chapters that deal with ethical and legal perspectives as well as one that covers competence in the field of driving capacity. In addition, the book contains short contributions on the situation in individual European countries.

Why is Competence Assessment Important? Development of the EDCON Consensus Statement.- EDCON-Consensus; Assessment of Competence.- Neuropsychological Assessment.- Brain Structures Inoalved in Dementia.- Medical Factors Interfering With Competence In Dementia.- Drugs That Affect Competence.- Who Decides Who Decides? Ethical Perspectives on Capacity and Decision-making.- Are Legal Systems in Europe Fit for The Dementia Challenge? Approach of The Council of Europe.- Testamentary and Financial Competence Issues in Dementia.- Assessment of Competency and Advance Directives.- Informed Consent in Dementia Research.- Assessment of Fitness to Drive, Possession of Professional Drivers' License, Possession of Firearms, and Pilot's Certificate in Clients with Dementing Conditions.- Practice of Competence Assement in Dementia; Austria.- Practice of Competence Assessment in Dementia; Denmark.- Practice of Competence Assessment in Dementia; Finland.- Practice of Competence Assessment in Dementia: France.- Practice of Competence Assessment in Dementia: Germany.- Practice of Competence Assessment in Dementia: Greece.- Practice of Competence Assessment in Dementia: Ireland.- Practice of Competence Assessment in Dementia: Italy.- Practice of Competence Assessment in Dementia: The Netherlands.- Practice of Competence Assessment in Dementia: Norway.- Practice of Competence Assessment in Dementia: Poland.- Practice of Competence Assessment in Dementia: Portugal.- Practice of Competence Assessment in Dementia: Romania.- Practice of Competence Assessment in Dementia: Spain.- Practice of Competence Assessment in Dementia: Sweden.- Practice of Competence Assessment in Dementia: Switzerland.- Practice of Competence Assessment in Dementia: Czech Republic.- Practice of Competence Assessment inDementia: UK.