California Conservatorships: Navigating the Maze with Capacity Testing

Today I wanted to delve into a complex legal and psychological issue in California: conservatorships and capacity testing. This topic often arises with aging loved ones, and navigating these decisions can feel overwhelming. But there is help and guidance available. I have worked with many families in Los Angeles to understand capacity and conservatorship from a psychological perspective, and have conducted capacity assessments in a wide variety of cases. Here’s how capacity testing can help ensure a fair and informed process if you or a loved one are navigating the possibility of a petition for conservatorship.

What is a Conservatorship?

A California conservatorship is a court-ordered legal arrangement where someone (the "conservator") is appointed to make decisions on behalf of another adult (the "conservatee") who is deemed unable to care for themselves or their finances. This can involve decisions about:

• Personal needs: Food, clothing, shelter, and medical care.

• Financial management: Paying bills, managing investments, making changes to a will or testament, and protecting assets from exploitation.

Why is Capacity Testing Important?

Capacity testing is a crucial component of the conservatorship process. It's a psychological evaluation that assesses an individual's ability to make informed decisions in specific areas. In the context of conservatorship, this typically focuses on two key domains:

1. Personal Needs Management: Can the individual safely manage their daily activities like preparing meals, dressing themselves, and taking medications?

2. Financial Management: Can the individual understand financial statements, avoid undue influence from others, and make sound financial decisions that are consistent with their values and well-being?

The Testing Process:

There's no single "capacity test." Evaluations involve a multi-pronged approach:

• Interviews: This involves gathering information from the individual, family members, and caregivers about their daily lives, decision-making processes, and any concerns.

• Cognitive Assessments: Standardized tests are used to assess memory, attention span, problem-solving skills, and judgment. These tests provide objective data about the individual's cognitive abilities. Just because someone has cognitive deficits or even dementia, does NOT mean they lack capacity. This information is crucial as part of a thorough evaluation, but it’s not the whole story. Many people with dementia maintain their capacity for decision-making, particularly if they have an established routine and support from family.

• Functional Assessments: Here, the psychologist observes the individual performing daily tasks related to finances and personal care, such as paying a bill. This may also involve asking test questions that get at a person’s comprehension and understanding of these tasks. For example, I may ask what someone would do in a hypothetical situation, such as if they accidentally cut their hand while alone at home, or ask them to explain a complex concept, such as health insurance. This helps determine their ability to function independently in real-world situations.

Importance of Capacity Testing in California:

• Accurate Information for the Court: Objective data from capacity testing helps judges make informed decisions about the necessity and extent of a conservatorship. It ensures the least restrictive option is considered to protect the individual's autonomy.

• Focus on Function, Not Diagnosis: California law emphasizes an individual's ability to function in daily life, not just a specific medical diagnosis. Capacity testing helps determine whether they can manage essential tasks independently.

• Protecting Well-Being: A conservatorship can be crucial if someone is vulnerable to financial exploitation, neglect, or self-harm due to impaired decision-making capacity. It provides a safety net until their abilities are restored or a less restrictive alternative is found.

California-Specific Considerations:

• Culturally Sensitive Evaluations: California recognizes the importance of cultural sensitivity in evaluations. Qualified psychologists consider the individual's cultural background, language, and values when conducting assessments.

• Least Restrictive Alternative: The court prioritizes options that allow the individual to retain as much autonomy as possible. A full conservatorship is only considered if less restrictive alternatives, like supported decision-making, are deemed insufficient.

Seeking Help:

If you're concerned about a loved one's ability to care for themselves or their finances, here are some resources to help you navigate the process:

• Consult with an attorney specializing in elder law or conservatorship. They can guide you through the legal aspects of conservatorship and the court process.

• Seek a licensed psychologist with experience in geriatric assessments and capacity testing, like Dr. Reger.  I can conduct a comprehensive evaluation and provide a report for your records, as well as complete any court forms, such as the GC-335 or a notarized declaration regarding capacity if those are needed and appropriate for your case.

• Contact your local Adult Protective Services agency for support and guidance. They can provide information on available resources and advocate for your loved one's well-being.

Remember: Conservatorship is a significant legal decision, and the process can be emotionally charged. Capacity testing ensures that decisions are made based on objective information, protecting the well-being of your loved one while respecting their autonomy to the greatest extent possible.

Let's Talk About a Capacity Assessment in Los Angeles, CA!

Have questions about California conservatorship, capacity testing, or resources for getting help? Feel free to reach out to Dr. Reger for support. You can learn more about the benefits of testing and more by following these simple steps:

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

2. Meet with Dr. Reger for an evaluation

3. Start navigating the complexities of capacity assessments!

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

Capacity assessments are not the only service offered by my Redondo Beach-based practice. I know that you may encounter more than one mental health concern at a time. This is why I’m happy to offer multiple 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, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!

Neuropsychological Assessments in California Workers' Compensation Cases – A Short Guide for Defense and Applicant Attorneys

As a defense or applicant attorney in California workers' compensation cases, you're likely familiar with the complexities surrounding head injuries, strokes, and other neurological issues that arise in the course of employment. Understanding the role and nuances of neuropsychological assessments can be crucial for building strong cases and advocating for your clients.

For Defense Attorneys:

Evaluating the Validity of Claims:

A neuropsychological assessment is often a valuable tool in evaluating the legitimacy of a claimant's cognitive complaints. The objective data obtained can identify inconsistencies between self-reported symptoms and test results, potentially revealing issues of exaggeration or malingering. Although there is no perfect way to assess for malingering of cognitive or emotional problems, well-validated tests designed to measure effort and performance validity are one of the best and most evidence-based options.

Assessing the Extent of Impairment:

While subjective reports of cognitive difficulties are present in many work injury cases, a neuropsychological assessment provides a more concrete picture of the functional limitations caused by the alleged injury. This information can be critical when determining the extent of disability and have a major impact when negotiating settlements.

Developing Return-to-Work Strategies:

Identifying the specific cognitive strengths and weaknesses of the claimant via neuropsych testing allows for the development of targeted recommendations for accommodations, work restrictions, and treatment to facilitate a safe and effective return to work. This can benefit both your client, by minimizing long-term disability, and the employer, by reducing lost productivity costs. And, as a bonus, this also helps the injured worker get back to work and move on with their life!

For Applicant Attorneys:

Building a Strong Case for Benefits:

A comprehensive neuropsychological assessment can significantly strengthen your client's claim for compensation by providing objective evidence of cognitive impairments directly linked to the work injury. This scientific data carries significant weight compared to solely relying on subjective complaints, and in cases where the neuroimaging doesn’t show structural changes (which is often the case in mild or moderate brain injuries), neuropsych testing can validate a person’s subjective report.

Maximizing Recovery:

Understanding the nature and severity of cognitive impairments helps develop tailored treatment plans and rehabilitation programs, aiming for optimal recovery and potential vocational retraining. This can significantly improve your client's long-term well-being and earning capacity.

Addressing Malingering Concerns:

A thorough neuropsychological assessment conducted by a reputable professional minimizes the risk of malingering accusations. The in-depth evaluation process and standardized testing protocols are designed to detect inconsistencies and ensure the assessment's validity.

Key Considerations for Both Sides:

Choosing the Right Expert:

Since neuropsych is not its own QME specialty, you will most likely need to seek out a clinical psychologist with specialty training in neuropsychological assessment as an Independent or Agreed Medical Evaluator. This can feel daunting, but here are a few tips.

This does not necessarily have to be a neuropsychologist, as long as the doctor has training and experience in neuropsychological assessment.

For example, I identify professionally as a clinical psychologist because I did not select an exclusively neuropsych training track when I got my doctorate and did my postdoctoral training. However, I did a great deal of psych and neuropsych assessment training throughout my education and fellowship in geropsychology (which requires expertise in neuropsych testing, among other things), including at highly regarded clinics like Cleveland Clinic, the UCSF Memory and Aging Center, and the San Francisco VA. I then went on to work in a rehabilitation/gero psychology setting, where I developed and directed the neuropsych assessment clinic in Spinal Cord Injury, and later directed the predoctoral psychology training program at the Long Beach VA. Now I run my own assessment and treatment practice.

As you can see, I have plenty of excellent training and experience with neuropsych assessment, but because I also do treatment, capacity assessment, and medical psychology, I don’t call myself a neuropsychologist; it is only one aspect of my work. So, let me be the example that broadening your search, from only self-proclaimed neuropsychologists to include clinical psychologists with experience and competence in neuropsych, might open up some doors in terms of finding an AME to do neuropsych evals in your cases.

Board certification is a great way for neuropsychologists to legitimize themselves in the field of neuropsychology.

However, board certification is not as emphasized or necessary in the field of psychology as it is in the medical field. According to the American Psychological Association, only about 4% of psychologists in the US are board certified, and I am confident there are many more than this who are highly trained, competent, and doing excellent work. Board certification is great, but it is only one marker of a high-quality psychologist.

Selecting a qualified and experienced psychologist with competence in neuropsych and workers' compensation cases is crucial. Look for professionals who adhere to best practices and have a track record of producing reliable and defensible reports; finding referrals by word of mouth is usually a good idea. A good psychologist doing neuropsych evals in work comp cases should approach from an objective lens and be honest about their findings, and in fact, this is an ethical obligation.

As psychologists, our job is not to support an attorney’s or injured worker’s opinions or desires; it’s to consider the data objectively and explain it honestly in a way that non-psychologists can understand. If an expert guarantees their findings will support your side of the case, they are overpromising and may not be credible under scrutiny!

Understanding the Assessment Process:

Both parties should have a basic understanding of the assessment process, including the types of tests administered, the information gathered, and the typical timeline for receiving the report.

Open Communication and Collaboration:

Open communication and collaboration between attorneys and the psychologist can ensure a smooth and efficient evaluation process, ultimately benefiting everyone involved by expediting resolutions and ensuring fair outcomes.

Start a neuropsychological evaluation in los angeles, ca

Neuropsychological assessments are not a perfect tool, but they can be valuable in navigating the complexities of workers' compensation cases that involve a neurologic injury with cognitive symptoms. Understanding their role and the nuances allows defense and applicant attorneys to effectively advocate for their clients and achieve fair and just outcomes. As a psychologist, I would be happy to offer support with a neuropsychological evaluation and other services. Start the evaluation process with Dr. Reger by following these simple steps:

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

2. Meet with Dr. Reger for an evaluation

3. Get a better understanding of neurological issues!

Disclaimer: This blog post is intended for informational purposes only and should not be construed as legal or medical advice. Always consult with qualified legal and medical professionals regarding your specific situation.

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

Neuropsychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. This is why I’m happy to offer multiple psychological assessments as well. Other assessments include capacity assessments, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!

Understanding Adult Psychodiagnostic Evaluations

If you've been struggling with mental health concerns that seem difficult to define, or if past treatments haven't yielded the results you'd hoped for, you might be a good candidate for a psychodiagnostic evaluation. People might find the idea of a psychodiagnostic evaluation (or even anything to do with a psychologist!) intimidating or mysterious, but this type of assessment provides a valuable opportunity to gain deeper insight into what may be driving your experiences and a path forward. I do psych evals with adults, and here is some information that you might find helpful if you’re considering an assessment.

What Exactly Is a Psychodiagnostic Evaluation?

Think of it as a comprehensive psychological detective mission focused on precisely understanding what's happening beneath the surface of how you think, feel, and behave. A psych eval goes beyond a few small questionnaires. In an adult psychodiagnostic eval, a skilled psychologist dives into:

• Deep-Dive Interview(s): I will get to know you through a thorough exploration of your personal history, current symptoms, and everyday experiences. In some cases, it’s also important to interview someone close to you, who can speak to what they have observed; this could be a parent, partner, caregiver, or close friend. Obviously, this type of additional interview is only with your consent.

• Testing and Measures: A carefully chosen battery of tests will shed light on your thought patterns, personality traits, and emotional states. This is tailored to your personal reasons for doing testing.

• Medical Records: Sometimes, though not in every case, I will want to look at past medical records relevant to the evaluation, for example, a cognitive assessment you did while in school for testing accommodations or records related to therapy, a brain injury, or a hospital stay.  

Why Seek a Psychodiagnostic Evaluation?

Several compelling reasons exist for seeking out a psychological evaluation:

Untangling Diagnostic Confusion:

Is it depression or bipolar disorder? Social anxiety or a posttraumatic stress disorder? A psychodiagnostic evaluation helps determine the accurate diagnosis (or diagnoses) even when the picture is complex. This is the number one reason I see adults for psych testing; they know something is going on and want to get a clear diagnosis.

Personalized Treatment Planning:

Diagnostic clarity and a deep understanding of your emotional and psychological landscape allow your psychologist to tailor a treatment plan to your needs. The right resources, education, therapy, medication (if appropriate), and support system become far more effective with a clear diagnosis.

Understanding and Validation:

In my experience, although it can be painful to get a psychological diagnosis, most people also feel a profound sense of relief when a diagnosis finally makes sense and validates their struggles. Understanding the nature of your mental health challenges is inherently empowering because it makes sense of things that have happened in your past and gives you a lens for understanding yourself. It can also help you give yourself some grace and compassion, rather than being hard on yourself for the ways you may be different from others in your life.

Identifying Strengths:

While focusing on challenges, a psychodiagnostic evaluation also illuminates your strengths and resilience. This creates a balanced, complete picture of who you are and the resources available to you in moving forward. 

What Happens During the Evaluation Process?

Although a psych eval will be tailored to your specific needs, most psychodiagnostic evaluations generally involve:

1. Initial Intake: You'll collaborate with your psychologist on understanding your concerns and goals, as we gather background information.

2. The Evaluation Itself: This typically spans several hours, or sometimes multiple sessions, and includes the interview(s), testing elements, and possibly observations.

3. Results and Feedback: I will carefully analyze the information gathered and share my findings. This includes clear explanations of the diagnosis, potential contributing factors, and your unique areas of strength. In my practice, I spend a great deal of time and energy scoring and interpreting the test results and writing up a comprehensive report for you. Although it’s many hours of work, this is helpful, because then you always have a record of that day – what your history was up to that point, your presenting concerns that day, your test results at that time, and my professional recommendations in black and white. The report gives you a reference to guide your treatment and lifestyle changes, and acts as a great baseline for comparison in the future.

4. Recommendations: As mentioned, in the report, you'll receive tailored treatment recommendations, which might include specific therapies, medication options, lifestyle adjustments, recommended readings or other tools for understanding your diagnosis, or resources for additional support, such as a referral for executive coaching or a support group.

Common Fears and Misconceptions

Feeling a bit nervous about this process is perfectly normal! Here's why you can relax:

• Judgment-Free Zone: I see evaluations as collaborative. I am not judging you but seeking to understand so I can help.

• It's Not About Labels: While precise diagnosis is valuable, a diagnostic label doesn't define you. This is only a tool for unlocking personalized support and self-understanding. I also believe that finally getting the correct diagnosis, sometimes after years of misdiagnosis or imprecise care, can allow you to move beyond the label in a way that being in the dark can’t.

• You're In Control: You participate every step of the way. You can ask questions, share what feels comfortable, take your time, and decline any tests you don't want to take.

Empowering Yourself: When to Consider an Evaluation

If any of these resonate, feel free to reach out to me about a psychodiagnostic evaluation:

• Previous treatments haven't produced the desired outcome.

• You suspect there's more going on than your current diagnosis suggests.

• You want a truly personalized plan for improved mental health.

• You long for a clearer understanding of yourself and your experiences.

• You have adopted negative beliefs about yourself as a result of mental health challenges, and these beliefs hold you back at your job, in relationships, or from personal growth.

A Journey Worth Taking

While it requires an investment of time, money, and effort, a psychodiagnostic evaluation often proves incredibly beneficial. Think of it as an investment in yourself – a chance to understand unanswered questions that hold you back and step into the clarity that allows healing and growth. As a psychological evaluator in Los Angeles, Dr. Reger would be honored to provide support in better understanding your mental health concerns. You can start the evaluation process by following these simple steps:

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

2. Meet with Dr. Reger for an evaluation

3. Start addressing the mental health challenges affecting you most!

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

Psychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. This is why I’m happy to offer multiple neuropsychological assessments. Other assessments include capacity assessments, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!

Top 10 Reasons to Get Neuropsych or Psych Testing in Los Angeles: Maintaining Brain Health and Emotional Wellbeing in the City of Angels

As a Los Angeles-based clinical psychologist specializing in neuropsychological assessment, I sometimes encounter confusion or hesitation when discussing cognitive testing – what exactly is it and why might someone need a neuropsych eval? Amidst the sunshine and diverse life of LA, prioritizing brain health is crucial so we can make the most of the wonderful city we live in. Here are 10 common reasons why cognitive testing can be valuable for Angelenos:

Navigate Hollywood's Demanding Environment:

Actors, musicians, and creatives in LA's competitive scene can benefit from understanding their cognitive strengths and weaknesses to optimize performance and manage demanding schedules. Sometimes, great creativity can come with intense emotions, problems with attention and follow-through, or other mental health concerns. A psychological assessment can also help with a diagnosis and getting the right support for a balanced life and self-care.

Stay Active and Independent:

Seniors in LA who cherish their active lifestyles sometimes want a neuropsychological evaluation to monitor mental fitness and identify any concerns early, ensuring continued independence, early intervention for any brain health concerns, and participation in the city's diverse offerings.

Address the Unique Challenges of a Multicultural City:

LA's large and diverse population means we need culturally competent providers in all areas to ensure accurate results and avoid bias. As a clinical psychologist who trained in Las Vegas and San Francisco before coming to LA 10 years ago, I have experience providing compassionate, culturally-informed care for patients crossing many varied identities – ethnicity, gender identity, sexual orientation, neurodivergence, disability status, age, socioeconomic status, immigrant status, and religious background. I am committed to educating myself, checking my own bias, and approaching each psych assessment, capacity evaluation, and neuropsych eval with cultural humility.

Access Renowned Research Opportunities:

UCLA, USC, and other research institutions in LA offer opportunities to participate in cutting-edge studies on brain health and cognition. Sometimes cognitive testing is a gateway to contributing to scientific advancements in this city!

Manage the Stress of LA Life:

From traffic jams and high cost of living to competitive environments, LA can also be stressful. A psych assessment in Los Angeles can identify potential emotional, social, and cognitive impacts of stress and guide you toward effective stress management strategies.

Make Informed Decisions about Retirement:

Whether enjoying the beaches or exploring local culture, Angelenos planning for retirement, either well in advance or coming soon, can use a neuropsychological assessment to get a baseline measurement of brain health, which improves readiness for the future, and can help with early identification of any concerning patterns. I have seen many patients who use their neuropsych evaluation results to make informed decisions about future care and living arrangements.

Support Loved Ones:

If you're concerned about a loved one's cognitive abilities or capacity to continue living on their own or manage finances, neuropsych testing conducted by a Los Angeles psychologist can provide insight, clear and personalized treatment recommendations, and guide you towards local support groups, resources, and care options.

Get Answers:

Many adults live with unexplained symptoms that have a real negative impact on every life, such as attention problems that get in the way of work and relationships, lifelong difficulty in social situations that they’ve never understood, or intense highs and lows in mood.  Angelenos can seek psych testing to finally get answers about those symptoms, as well as an understanding of how to manage them for a balanced life and well-being.

Find Personalized Brain Fitness Solutions:

From executive function coaches to mindfulness groups, LA boasts a plethora of brain-healthy activities, and I am connected with many professionals in a variety of fields doing excellent work. Neuropsych testing can help personalize your approach and maximize the benefits of these resources.

Embrace a Holistic Approach to Wellness:

In the wellness-conscious culture of LA, cognitive testing or psychological testing complements your dedication to physical and mental fitness, providing a complete picture of your overall well-being.

Begin Neruopsych or Psychological Testing in Los Angeles, CA

A psych assessment or neuropsych assessment is an investment in your future. You are always welcome to reach out to me as a qualified Los Angeles-based psychologist to discuss your unique needs and explore whether testing is right for you. Take charge of your brain health and embrace the vibrant life LA offers with confidence and clarity by following these simple steps:

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

2. Meet with a Los Angeles Psychologist for an evaluation

3. Start receiving the support your loved ones deserve!

OTHER SERVICES OFFERED BY DR. REGER IN LOS ANGELES, CA

Psychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. This is why I’m happy to offer multiple neuropsychological assessments. Other assessments include capacity assessments, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!