Undue Influence and Capacity Assessment: Protecting Vulnerable Adults

As a psychologist, I often encounter situations where the decision-making abilities of older adults or individuals with cognitive impairments are called into question. In these cases, it's crucial to carefully assess not only the individual's capacity but also the presence of any undue influence. Undue influence can be complicated, as there are many interpersonal and relationship factors that come into play, as well as personal values that are hard for outsiders to quantify. My role in these cases is to provide capacity assessment and evaluate the totality of a person’s situation and decisions to help determine whether undue influence is an issue.

What is Undue Influence?

Undue influence occurs when a person uses improper methods to persuade another person to make a decision they would not otherwise make. This can involve:

• Coercion: Using threats, intimidation, or pressure to force someone to make a decision.

• Manipulation: Using deception, flattery, or emotional appeals to exploit someone's vulnerabilities.

• Isolation: Isolating the individual from trusted friends, family, or advisors.

• Exploitation: Taking advantage of the individual's financial, emotional, or physical needs for personal gain.

Signs of Potential Undue Influence:

• Sudden and unexplained changes in behavior or lifestyle.

• Isolation from family and friends.

• Unusual or suspicious financial transactions.

• Rapidly changing wills or other legal documents.

• A new and dominant relationship with a caregiver or other individual.

• The individual expressing fear or anxiety about making decisions.

The Role of the Psychologist in Assessing Capacity and Undue Influence

Psychologists play a vital role in assessing both capacity and the potential for undue influence. Our assessments typically involve:

• Thorough clinical interviews: Assessing the individual's cognitive functioning, including memory, attention, judgment, and decision-making abilities. This can also include asking about history, values, and past decision-making.

• Review of medical records: Examining medical history, medications, and any existing diagnoses.

• Collateral interviews: Gathering information from family members, caregivers, and other relevant individuals.

• Observation of the individual's behavior: Observing their interactions with others and assessing their overall mental state.

Distinguishing Between Capacity Limitations and Undue Influence

It's important to distinguish between genuine capacity limitations and the effects of undue influence.

• Capacity limitations: These may involve cognitive impairments such as dementia, Alzheimer's disease, or other neurological conditions that affect an individual's ability to make sound judgments.

• Undue influence: This involves external pressures or manipulations that exploit an individual's vulnerabilities, regardless of their cognitive abilities.

Ethical Considerations

• Maintaining confidentiality: Psychologists have an ethical obligation to maintain confidentiality in all interactions with clients. However, there may be situations where it is necessary to breach confidentiality to protect the individual from harm.

• Avoiding conflicts of interest: Psychologists must avoid any situations that could create a conflict of interest, such as having a personal or financial relationship with any party involved in the case.

• Respecting the individual's autonomy: While protecting vulnerable adults is essential, it's crucial to respect their autonomy and right to make their own decisions whenever possible. This balance is at the heart of any capacity assessment.

Assessing capacity and identifying potential undue influence are complex and multifaceted tasks. Psychologists play a critical role in these evaluations, providing objective and unbiased assessments that can help protect vulnerable adults from exploitation and ensure that their rights and best interests are upheld.

Disclaimer: This blog post is for informational purposes only and should not be considered medical or legal advice.

Start Working with A Therapist for Older Adults in LA

If you or a loved one need support navigating cognitive concerns, decision-making, or undue influence, a therapist for older adults in LA can help. Contact Dr. Reger to schedule a consultation and ensure peace of mind for you and your family. You can start the therapy process by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an assessment

3. Start finding the support you deserve!

Other Services Offered by Dr. Reger in Los Angeles, CA

I am happy to offer support with a variety of services in addition to counseling for older adults. I also offer a variety of neuropsychological assessments in addition to ADHD testing. I am happy to offer capacity assessments, neuropsychological and psychological assessments, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, and mental health consultations and presentations. Visit my blog for more help today!

New Year, New You: Realistic Resolutions for Older Adults in Los Angeles

The vibrant city of Los Angeles offers endless opportunities for older adults to stay active, engaged, and fulfilled.

As the New Year begins, many of us are making resolutions to improve our health, happiness, and well-being. While these resolutions can be a powerful motivator for people of all ages, it's important to approach them with a realistic and age-appropriate mindset.

For older adults living in Los Angeles, the focus should shift from drastic overhauls to sustainable, enjoyable changes that enhance the quality of life within the unique context of Southern California. Here are a few ideas:

1. Embrace the LA Lifestyle:

• Explore the outdoors: Take advantage of LA's beautiful weather and diverse outdoor spaces. There are several low-key hikes in Griffith Park and other natural places around LA, or you can always hit your favorite beach!

• Embrace the arts and culture: Attend a concert at the Hollywood Bowl, visit a museum in Downtown LA, or catch a performance at the Geffen Playhouse.

• Utilize LA's transportation options: Explore the Metro system, utilize ride-sharing services, or consider joining a carpool to reduce reliance on driving.

2. Prioritize Physical Activity:

• Take advantage of LA's fitness scene: Join a senior fitness class at a local community center, explore free beach yoga classes in Long Beach, or find a meetup group that walks in your neighborhood.

• Find enjoyable activities: Choose activities you genuinely enjoy, whether it's walking along the Strand in the South Bay, dancing at a dance studio, or gardening in your backyard.

• Set realistic goals: Start with small, achievable goals and gradually increase the intensity and duration of your activities.

3. Nurture Social Connections:

• Reconnect with loved ones: Make an effort to spend quality time with family and friends.

• Join a social club or group: Explore local senior centers, book clubs, or volunteer opportunities to meet new people.

• Utilize LA's vibrant social scene: Attend community events, festivals, and cultural celebrations. Los Angeles has many free and low-cost cultural events going on all the time, and engaging with new communities and cultures is excellent for brain health in older adults!

4. Cultivate Mental Well-being:

• Practice mindfulness and relaxation techniques: Explore techniques like deep breathing, meditation, or progressive muscle relaxation to reduce stress and improve sleep.

• Engage in mentally stimulating activities: Visit the Getty Center, attend a lecture at UCLA, or join a writing workshop.

• Prioritize self-care: Make time for activities that bring you joy, such as enjoying a picnic in Griffith Park, or pursuing a hobby.

5. Focus on Nutrition and Hydration:

• Make small, manageable changes to your diet: Incorporate more fruits, vegetables, and whole grains into your meals.

• Stay hydrated: Drink plenty of water throughout the day, especially during the warmer months.

• Consult with a registered dietitian or a healthcare professional: They can provide personalized guidance on nutrition and hydration.

Important Considerations:

• Be patient and kind to yourself: It's okay to make mistakes and adjust your goals as needed.

• Celebrate your successes: Acknowledge and appreciate your accomplishments, no matter how small.

• Seek support: Don't hesitate to reach out to family, friends, or healthcare professionals for support and encouragement.

Remember, the goal of any resolution is to improve your overall well-being and quality of life and enjoy a fulfilling life in the vibrant city of Los Angeles. Prioritize your physical, mental, and emotional health, and focus on creating sustainable changes that bring you joy and satisfaction.

Start Therapy for Older Adults in Los Angeles, CA

Some people forego resolutions, and there shouldn’t be pressure to make resolutions. At the same time, striving to stay engaged at all ages is an important part of keeping a growth mindset as we age and is beneficial for brain health. As a therapist for older adults, Dr. Reger is happy to help improve your well-being and cultivate lasting changes. You can start your therapy journey by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an evaluation

3. Start making the most of the new year!

Other Services Offered by Dr. Reger in Los Angeles, CA

Therapy for older adults isn’t the only service offered at my Redondo Beach-based practice. In addition, I am happy to also offer capacity assessments, neuropsychological and psychological assessments, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, and mental health consultations and presentations. Visit my blog for more help today!

Disclaimer: This blog post is for informational purposes only and should not be considered medical advice.

Understanding Testamentary Wishes: A Psychologist's Perspective on Capacity Assessment

The Complexities of End-of-Life Decisions

As a geropsychologist (a psychologist specializing in aging), I often encounter individuals grappling with profound questions about life and death. One particularly sensitive area is the assessment of testamentary capacity, the ability to make sound decisions about one's estate and legacy. This involves understanding the nuances of a person's wishes, particularly when cognitive decline or mental health challenges may cloud judgment.

The Legal Framework

Testamentary capacity is a legal concept that varies across jurisdictions, and I work mostly in California. However, the core principles remain consistent across the US: a person must possess sufficient mental acuity to comprehend the nature and extent of their property, identify potential beneficiaries, and make rational decisions about the distribution of their assets.

The Psychological Perspective

While the legal framework provides a structured approach to assessing testamentary capacity, psychologists offer a deeper understanding of the cognitive and emotional factors that may influence a person's decision-making. We delve into questions such as:

• Cognitive Function: Does the individual have the mental capacity to understand complex legal and financial concepts? Can they appreciate the implications of their choices? Cognitive testing plays an important role when testamentary capacity is in question.

• Emotional State: Are they experiencing significant emotional distress or undue influence that might compromise their judgment? Is grief, untreated depression, or anxiety impacting their decisions?

• Vulnerability: Are there factors, such as isolation, dependency, or susceptibility to manipulation, that may render them vulnerable to exploitation?

The Role of the Psychologist

A psychologist can play a crucial role in the assessment of testamentary capacity by:

1. Conducting a Comprehensive Evaluation: This involves a thorough assessment of cognitive function, emotional state, and decision-making abilities.

2. Identifying Potential Biases or Undue Influence: Psychologists can uncover subtle pressures or manipulations that may influence a person's wishes.

3. Assessing the Impact of Psychiatric Diagnoses: Conditions like dementia, depression, or bipolar disorder can significantly impair judgment and decision-making.

4. Providing Expert Testimony: In legal proceedings, a psychologist's expert opinion can be invaluable in clarifying the mental state of an individual at a specific point in time. I have worked in many cases where a psychologist’s opinion is a crucial part of legal proceedings like establishing conservatorship.

Ethical Considerations

When assessing testamentary capacity, psychologists must adhere to strict ethical guidelines. This includes:

• Confidentiality: Protecting the privacy of the individual and maintaining confidentiality.

• Informed Consent: Ensuring that the individual understands the purpose of the assessment and the potential implications of the findings. In cases where a person’s cognitive function in in question, we still do our best to get consent from the person as well as any guardian, DPOA, or conservator who may make decisions on their behalf.

• Objectivity: Maintaining a neutral and objective stance, avoiding personal biases or prejudices.

• Beneficence: Acting in the best interests of the individual, even if it means challenging their wishes. The goal is always for the individual to retain as much independence and autonomy in decision-making as possible, while also maintaining safety and security.

A Delicate Balance

The assessment of testamentary capacity is a delicate balance between respecting an individual's autonomy and protecting them from harm. While it's essential to honor a person's wishes, it's equally important to ensure that those wishes are truly their own and not the product of cognitive impairment or undue influence.

Start an Assessment for Testamentary Capacity in Los Angeles, CA

By working collaboratively with legal professionals, medical practitioners, and family members, psychologists can provide valuable insights into the complex issues surrounding testamentary capacity. Ultimately, the goal is to ensure that a person's final wishes are honored while safeguarding their best interests. You can contact Dr. Reger for support with assessments and therapy services. Start your therapy journey by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an assessment

3. Start finding the support you deserve!

Other Services Offered by Dr. Reger in Los Angeles, CA

I am happy to offer support with a variety of services in addition to counseling for older adults. I also offer a variety of neuropsychological assessments in addition to ADHD testing. I am happy to offer capacity assessments, neuropsychological and psychological assessments, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, and mental health consultations and presentations. Visit my blog for more help today!

Navigating the Holidays: Tips for Older Adults

The holiday season, while often filled with joy and cheer, can also sometimes be a challenging time for older adults. The hustle and bustle, social pressures, and changing family dynamics can contribute to feelings of stress, loneliness, and anxiety. Grief can also be very heavy during the holiday season. As a psychologist, I've worked with many older adults who have found ways to navigate these challenges and embrace the holiday spirit.

Here are some tips to help older adults enjoy the season:

1. Set Realistic Expectations

• Avoid Overcommitting: It's okay to say no to invitations or obligations that may feel overwhelming. Asking ahead about accessibility can also help with this (for example, folks with mobility needs might want to know whether a host’s home has 20 steps to get into the front door).

• Pace Yourself: Spread out holiday activities over a longer period to avoid feeling rushed or exhausted. For example, if you’re baking or cooking, do parts as early as possible, and complete the work over several days, giving yourself plenty of time to rest if you need it.

• Prioritize: Focus on the most important traditions and activities that bring you joy. I have often talked with patients about the fact that “no” is a complete sentence!

2. Manage Stress and Anxiety

• Practice Mindfulness: Engage in mindfulness techniques like meditation or deep breathing to reduce stress and anxiety. The best way to start a mindfulness practice is to practice daily at a set time to build the skill into your routine.

• Seek Social Support: Spend time with loved ones who provide positive and supportive company.

• Limit Stressors: Reduce exposure to stressful situations, such as crowded shopping malls or noisy parties.

3. Adapt Traditions

• Modify Traditions: If certain traditions become too difficult, stressful, or too painful because of grief, consider modifying them or creating new ones.

• Embrace New Experiences: Be open to trying new things and creating new holiday memories.

• Focus on the Positive: Shift your focus from what you can't do to what you can.

4. Stay Connected

• Virtual Connections: Use technology to stay connected with loved ones who live far away. Watch a tutorial on how to use Zoom or Facetime if you haven’t learned yet, or ask a family member or friend for help if you need it.

• Join Social Groups: Participate in social groups or clubs to meet new people and form friendships.

• Volunteer: Giving back to the community can provide a sense of purpose and connection.

5. Prioritize Self-Care

• Get Enough Sleep: Aim for 7-8 hours of quality sleep each night.

• Eat Healthy: Maintain a balanced diet to support your physical and mental health.

• Exercise Regularly: Engage in regular physical activity to boost your mood and energy levels. Even simple movement is good for us!

• Seek Professional Help: If you're struggling with feelings of depression, anxiety, grief, or loneliness, which are often worse for people during the holidays, consider seeking therapy or counseling for support.

Common Challenges and Strategies

• Loneliness: Spend time with loved ones, join social groups, volunteer, or consider getting a pet.

• Financial Stress: Create a budget, avoid impulse purchases, opt for homemade gifts like cookies, communicate with family and friends about budget boundaries, and seek assistance from social services if needed.

• Health Concerns: Consult with your doctor to manage any health conditions and create a holiday plan that accommodates your needs. 

• Grief and Loss: Allow yourself to grieve, seek support from loved ones or a grief counselor, and participate in memorial rituals to remember loved ones.

Start Therapy for Older Adults in Los Angeles, CA

Remember, the holidays are a time for joy and connection, but they can be particularly hard for older adults if loss, loneliness, disability, health concerns, or stress become overwhelming. Prioritize self-care this season! Dr. Reger can help you and your loved ones make the most of the holiday season. Start your therapy journey by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger

3. Start finding joy this holiday season!

Other Services Offered with Dr. Stacy Reger in Los Angeles, CA

Counseling for older adults isn’t the only service offered by Dr. Stacy Reger. Other services include capacity assessments and a variety of neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, and mental health consultations and presentations. Visit my blog for more help today!