Decision-Making Incapacity Among Nursing Home Residents: Results From the 1987 NMES Survey.
Behavioral Sciences and the Law
Recent legislative and regulatory developments have focused attention on older adults' capacity for involvement in health care decision-making. The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) focused attention on the rights of nursing home residents to be involved in health care decision-making to the fullest extent possible. This article uses data from the 1987 National Medical Expenditure Survey (NMES) to examine rates of incapacity for health care decision-making among nursing home residents. Elements of the Oklahoma statute were used to operationalize decision-making incapacity: disability or disorder, difficulty in decision-making or communicating decisions, and functional disability. Fifty-three percent of nursing home residents had a combination of either physical or mental impairment and an impairment in either self-care or money management. The discussion focuses on the policy and practice implications of significant rates of incapacity among nursing home residents.
Smyer, Michael A.; Goodwin, Paige; and Lair, Tamra. "Decision-Making Incapacity Among Nursing Home Residents: Results From the 1987 NMES Survey.." Behavioral Sciences and the Law 13, (1995) : 405-414.