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A novel tool to assess the capacity of people with dementia to designate a surrogate.

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Title: A novel tool to assess the capacity of people with dementia to designate a surrogate.
Authors: Stahl, Devan1 (AUTHOR), Wasserman, Jason Adam2 (AUTHOR), Barron, Lauren3 (AUTHOR), Weaver, Sally P4 (AUTHOR)
Source: Gerontologist. Dec2025, Vol. 65 Issue 12, p1-9. 9p.
Subject Terms: *Alzheimer's disease, *Decision making, *Research methodology, *Inter-observer reliability, Treatment of dementia, Capacity (Law), Patients' rights, Statistical significance, Research funding, Research evaluation, Descriptive statistics, Patient-centered care, Thematic analysis, Nursing care facilities, Sound recordings, Cognition disorders, Conceptual structures, One-way analysis of variance, Dementia, Guardian & ward, Data analysis software, Medical ethics, Advance directives (Medical care)
Abstract: Background and Objectives As their cognitive function declines, people with dementia often lose decision-making capacity (DMC) for choosing certain medical treatments, but some retain the capacity to designate a surrogate (CDS) decision maker. There is currently no tool for assessing the CDS. The purpose of this study is to validate a novel capacity assessment tool for evaluating CDS for people with a clinical diagnosis of dementia. Research Design and Methods A concurrent mixed-methods design was used to evaluate 52 participants' ability to (a) consistently name a surrogate, (b) understand the role of the surrogate, and (c) provide a rationale for why they chose their surrogate. A basic difference of means was used to test differences in CDS scores between participants who had and did not have DMC. Thematic analysis was applied to the narrative data on reasons for the participants' choice of surrogate. Results The CDS instrument demonstrated high interrater reliability and evidence of validity. On every dimension, the CDS tool identified participants who otherwise lacked DMC who nonetheless had full understanding of the need, process, and role of a surrogate. Thematic analysis revealed 33 unique reasons participants chose their surrogate, which were then grouped into three overarching themes. Discussion and Implications The CDS tool shows that there are patients who may otherwise lack DMC but who can validly designate a surrogate. The CDS tool may be a highly useful instrument to promote patient-centered care among vulnerable patients deemed to lack capacity for treatment decisions. [ABSTRACT FROM AUTHOR]
Copyright of Gerontologist is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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PubType: Academic Journal
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Items – Name: Title
  Label: Title
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  Data: A novel tool to assess the capacity of people with dementia to designate a surrogate.
– Name: Author
  Label: Authors
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  Data: <searchLink fieldCode="AR" term="%22Stahl%2C+Devan%22">Stahl, Devan</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wasserman%2C+Jason+Adam%22">Wasserman, Jason Adam</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barron%2C+Lauren%22">Barron, Lauren</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Weaver%2C+Sally+P%22">Weaver, Sally P</searchLink><relatesTo>4</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Gerontologist%22">Gerontologist</searchLink>. Dec2025, Vol. 65 Issue 12, p1-9. 9p.
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  Data: *<searchLink fieldCode="DE" term="%22Alzheimer's+disease%22">Alzheimer's disease</searchLink><br />*<searchLink fieldCode="DE" term="%22Decision+making%22">Decision making</searchLink><br />*<searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br />*<searchLink fieldCode="DE" term="%22Inter-observer+reliability%22">Inter-observer reliability</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+of+dementia%22">Treatment of dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Capacity+%28Law%29%22">Capacity (Law)</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+rights%22">Patients' rights</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+significance%22">Statistical significance</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Research+evaluation%22">Research evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Patient-centered+care%22">Patient-centered care</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Nursing+care+facilities%22">Nursing care facilities</searchLink><br /><searchLink fieldCode="DE" term="%22Sound+recordings%22">Sound recordings</searchLink><br /><searchLink fieldCode="DE" term="%22Cognition+disorders%22">Cognition disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Conceptual+structures%22">Conceptual structures</searchLink><br /><searchLink fieldCode="DE" term="%22One-way+analysis+of+variance%22">One-way analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Dementia%22">Dementia</searchLink><br /><searchLink fieldCode="DE" term="%22Guardian+%26+ward%22">Guardian & ward</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+ethics%22">Medical ethics</searchLink><br /><searchLink fieldCode="DE" term="%22Advance+directives+%28Medical+care%29%22">Advance directives (Medical care)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and Objectives As their cognitive function declines, people with dementia often lose decision-making capacity (DMC) for choosing certain medical treatments, but some retain the capacity to designate a surrogate (CDS) decision maker. There is currently no tool for assessing the CDS. The purpose of this study is to validate a novel capacity assessment tool for evaluating CDS for people with a clinical diagnosis of dementia. Research Design and Methods A concurrent mixed-methods design was used to evaluate 52 participants' ability to (a) consistently name a surrogate, (b) understand the role of the surrogate, and (c) provide a rationale for why they chose their surrogate. A basic difference of means was used to test differences in CDS scores between participants who had and did not have DMC. Thematic analysis was applied to the narrative data on reasons for the participants' choice of surrogate. Results The CDS instrument demonstrated high interrater reliability and evidence of validity. On every dimension, the CDS tool identified participants who otherwise lacked DMC who nonetheless had full understanding of the need, process, and role of a surrogate. Thematic analysis revealed 33 unique reasons participants chose their surrogate, which were then grouped into three overarching themes. Discussion and Implications The CDS tool shows that there are patients who may otherwise lack DMC but who can validly designate a surrogate. The CDS tool may be a highly useful instrument to promote patient-centered care among vulnerable patients deemed to lack capacity for treatment decisions. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Gerontologist is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=190629561
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1093/geront/gnaf259
    Languages:
      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 1
    Subjects:
      – SubjectFull: Alzheimer's disease
        Type: general
      – SubjectFull: Decision making
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Inter-observer reliability
        Type: general
      – SubjectFull: Treatment of dementia
        Type: general
      – SubjectFull: Capacity (Law)
        Type: general
      – SubjectFull: Patients' rights
        Type: general
      – SubjectFull: Statistical significance
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Research evaluation
        Type: general
      – SubjectFull: Descriptive statistics
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      – SubjectFull: Patient-centered care
        Type: general
      – SubjectFull: Thematic analysis
        Type: general
      – SubjectFull: Nursing care facilities
        Type: general
      – SubjectFull: Sound recordings
        Type: general
      – SubjectFull: Cognition disorders
        Type: general
      – SubjectFull: Conceptual structures
        Type: general
      – SubjectFull: One-way analysis of variance
        Type: general
      – SubjectFull: Dementia
        Type: general
      – SubjectFull: Guardian & ward
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Medical ethics
        Type: general
      – SubjectFull: Advance directives (Medical care)
        Type: general
    Titles:
      – TitleFull: A novel tool to assess the capacity of people with dementia to designate a surrogate.
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            NameFull: Stahl, Devan
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            NameFull: Wasserman, Jason Adam
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            – D: 01
              M: 12
              Text: Dec2025
              Type: published
              Y: 2025
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