Assessment of competence in dementia in europe. an initiative of the european consensus network (EDCON)

Abstract

The core symptom of dementia is intellectual impairment which leads to difficulties or incapacity of the suffering patients to decide relevant topics on their own. Important areas are the consent to diagnosis, treatment or hospital and nursing home admission, as well as testamentary and financial decisions, advance directives, participation in research and driving licence.

The (empirical) database is scarce. In addition, throughout Europe, legal and social conditions vary widely with only few (recently developed) laws taking the dementia problem into account. In some countries regular health checks in the elderly are already established at least with regard to driving license. Up to now the discussion is ongoing, whether these checks are really helpful or “expression” of ageistic attitudes in the (medical) society.

As a first step we performed a survey and approached national experts for dementia to answer a short questionnaire. It included questions concerning the main topics of testamentary and financial competence, informed consent, advance directives and driving. Representatives of 17 European countries answered and the results were discussed on an interdisciplinary (lawyers, legal medicine specialist, neuropsychologist, psychiatrist) expert workshop. The results and a preliminary consensus are presented.