What are some of the issues involved in assessing a person's ability to make decisions about their care?
ANSWER:
There is no uniform approach to establishing a resident's cognitive competence. One reason for this is that each state sets the criteria needed to demonstrate cognitive competence. There is also difficulty when trying to use family members as proxies because some research shows lack of congruence between what resident's want and what their families think they should want. There are also ethnic variations in these findings. Resolving this problem will have to be based on using the person- environment approaches to assess goodness of fit and strong clinical assessments, along with a thorough understanding of treatment goals and quality of life goals. This will take the collaboration of the resident, the family, and health professionals.
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