J Korean Neuropsychiatr Assoc.  2016 Aug;55(3):245-255. 10.4306/jknpa.2016.55.3.245.

A Provincial Population-Based Survey on Attitudes towards Wills of Individuals with Dementia and Related Issues

Affiliations
  • 1Department of Psychiatry, Jeonbuk Provincial Maeumsarang Hospital, Wanju, Korea. tyhwang73@naver.com
  • 2Jeonbuk Dementia Center, Jeonju, Korea.
  • 3Insan Research Institute for Psychiatry, Jeonbuk Provincial Maeumsarang Hospital, Wanju, Korea.

Abstract


OBJECTIVES
This study investigated the attitudes of a provincial population towards wills of individuals with dementia and related concerns to prevent civil disputes related to dementia in an aging society.
METHODS
The target population was registered residents in a province aged 19 years or older. The population forming the sampling frame was 1478821 (as of May 31, 2013). With a confidence interval of 2% and significance level of 5%, 2540 participants were sampled. This survey used a structured questionnaire composed of two main parts : seven items of general information (sex, age, residence, marital status, education, occupation, and income) and Testamentary Capacity-Related Questionnaire-12 items (TCRQ-12) comprising four items of basic knowledge and eight items of specific situational questions, using a five point Likert scale.
RESULTS
The respondents were favorable toward the guarantee of will-making capacity of individuals with dementia. Self-relatedness, disadvantageousness and undue influence are significantly associated with objection to the will of individuals with dementia. In the pre-evaluation of testamentary capacity of individuals with dementia, the respondents responded strongly and with more favorable attitudes for evaluation by medical specialists than by lawyers. Last, in acceptance of the denial of self-related will due to dementia, negative response was dominant over positive response.
CONCLUSION
Although it would be desirable that the will or testamentary capacity of individuals with dementia should be guaranteed for maximum, institutional and professional approaches are necessary to prevent civil disputes related to dementia.

Keyword

Dementia; Will; Testamentary capacity; Attitude; Survey

MeSH Terms

Aging
Dementia*
Denial (Psychology)
Dissent and Disputes
Education
Health Services Needs and Demand
Humans
Lawyers
Marital Status
Occupations
Specialization
Surveys and Questionnaires

Figure

  • Fig. 1 Attitudes towards the restriction or guarantee of the will-making capacity of individuals with dementia. The boxplots in the figure show response distribution for the comparison between Question No. 5 and 6. The respondents showed relatively favorable attitudes for the guarantee of will-making or testamentary capacity of individuals with dementia [restriction although mild, 2.80 (1.07) vs. guarantee although severe, 3.13 (1.06); paired t-test, t=-11.27, p<0.001].

  • Fig. 2 Attitudes towards objection to the will of individuals with dementia due to related factors. The boxplots in the figure show the comparison among Question No. 7, 8, and 9. Self-relatedness, disadvantageousness and undue influence are significant factors contributing to objection to the will of individuals with dementia [objection just for dementia (a), 3.11 (1.02) vs. objection due to disadvantageousness (b), 3.23 (1.04) vs. objection due to disadvantageousness and undue influence (c), 3.39 (1.13); ANOVA, F=86.44, p<0.001; post hoc analysis (Scheffe), a

  • Fig. 3 Attitudes towards professional pre-assessment of testamentary capacity of individuals with dementia. The boxplots in the figure shows the response distribution for the comparison between Question No. 10 and 11. The respondents showed responses more favorable for the evaluation by medical specialists than by lawyers [lawyers, 3.31 (1.13) vs. medical specialists, 3.40 (1.10); paired t-test, t=-4.92, p<0.001].


Reference

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Arlington, VA: American Psychiatric Association;2013.
2. Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock's synopsis of psychiatry behavioral sciences/clinical psychiatry. 11th ed. Philadelphia, PA: Wolters Kluwer;2015. p. 704–715.
3. Kosis.kr [homepage on the Internet]. Population projections: general and processed statistics, statistics on population. cited 2013 May 31. Available from: http://www.kosis.kr.
4. Youn JC, Lee DY, Kim KW, Woo JI. Epidemiology of dementia. Psychiatry Investig. 2005; 2:28–39.
5. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013; 9:63–75.
Article
6. Kim KW, Park JH, Kim MH, Kim MD, Kim BJ, Kim SK, et al. A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea. J Alzheimers Dis. 2011; 23:281–291.
Article
7. Kim YJ, Han JW, So YS, Seo JY, Kim KY, Kim KW. Prevalence and trends of dementia in Korea: a systematic review and meta-analysis. J Korean Med Sci. 2014; 29:903–912.
Article
8. Kang IO, Lee SY, Kim SY, Park CY. Economic cost of dementia patients according to the limitation of the activities of daily living in Korea. Int J Geriatr Psychiatry. 2007; 22:675–681.
Article
9. Banerjee S. The macroeconomics of dementia--will the world economy get Alzheimer's disease. Arch Med Res. 2012; 43:705–709.
Article
10. Foot DK, Stoffman D. Boom, bust and echo. Toronto: Stoddart;2002.
11. Shulman KI, Cohen CA, Hull I. Psychiatric issues in retrospective challenges of testamentary capacity. Int J Geriatr Psychiatry. 2005; 20:63–69.
Article
12. Shulman KI, Cohen CA, Kirsh FC, Hull IM, Champine PR. Assessment of testamentary capacity and vulnerability to undue influence. Am J Psychiatry. 2007; 164:722–727.
Article
13. Rcps.egov.go.kr [homepage on the Internet]. Population stastics on registration of resident. cited 2013 May 31. Available from: http://rcps.egov.go.kr:8081/jsp/stat/ppl_stat_jf.jsp.
14. Surveysystem.com [homepage on the Internet]. Research aids: sample size calculator and sample size formula. cited 2013 May 31. Available from: http://www.surveysystem.com.
15. Neufeld E, O'Rourke N, Donnelly M. Enhanced measurement sensitivity of hopeless ideation among older adults at risk of self-harm: reliability and validity of Likert-type responses to the Beck Hopelessness Scale. Aging Ment Health. 2010; 14:752–756.
Article
16. Peer IN. Wills, testamentary capacity and undue influence. Bull Am Acad Psychiatry Law. 1981; 9:15–22.
17. Wimo A, Jönsson L, Bond J, Prince M, Winblad B. Alzheimer Disease International. The worldwide economic impact of dementia 2010. Alzheimers Dement. 2013; 9:1–11.
Article
18. Quentin W, Riedel-Heller SG, Luppa M, Rudolph A, König HH. Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Acta Psychiatr Scand. 2010; 121:243–259.
Article
19. Schulz R, Martire LM. Family caregiving of persons with dementia: prevalence, health effects, and support strategies. Am J Geriatr Psychiatry. 2004; 12:240–249.
Article
20. Kim YH. A study on the formality of will in civil law. Res Fam Law. 2006; 20:117–160.
21. Jeon HJ. Study on the inheritance by will in Korean civil law. Res Fam Law. 2006; 20:151–180.
22. Peisah C, Finkel S, Shulman K, Melding P, Luxenberg J, Heinik J, et al. The wills of older people: risk factors for undue influence. Int Psychogeriatr. 2009; 21:7–15.
Article
23. Jacoby R, Steer P. How to assess capacity to make a will. BMJ. 2007; 335:155–157.
Article
24. Brown PF, Tulloch AD, Mackenzie C, Owen GS, Szmukler G, Hotopf M. Assessments of mental capacity in psychiatric inpatients: a retrospective cohort study. BMC Psychiatry. 2013; 13:115.
Article
25. Choi JS. [LAW & LIFE] Practical use of adult guardianship system for the protection of the elderly. Electric Power. 2016; 10:89.
26. Kennedy KM. Testamentary capacity: a practical guide to assessment of ability to make a valid will. J Forensic Leg Med. 2012; 19:191–195.
Article
27. Shulman KI, Peisah C, Jacoby R, Heinik J, Finkel S. Contemporaneous assessment of testamentary capacity. Int Psychogeriatr. 2009; 21:433–439.
Article
28. Banks vs Goodfellow. 1870. LR 5 QB 549.
29. Widera E, Steenpass V, Marson D, Sudore R. Finances in the older patient with cognitive impairment: "He didn't want me to take over". JAMA. 2011; 305:698–706.
Article
30. White B. Competence to consent. Washington, DC: Georgetown University Press;1994. p. 154–184.
31. Dunn LB, Nowrangi MA, Palmer BW, Jeste DV, Saks ER. Assessing decisional capacity for clinical research or treatment: a review of instruments. Am J Psychiatry. 2006; 163:1323–1334.
Article
32. Lui VW, Lam LC, Chau RC, Fung AW, Wong BM, Leung GT, et al. Structured assessment of mental capacity to make financial decisions in Chinese older persons with mild cognitive impairment and mild Alzheimer disease. J Geriatr Psychiatry Neurol. 2013; 26:69–77.
Article
33. Lai JM, Gill TM, Cooney LM, Bradley EH, Hawkins KA, Karlawish JH. Everyday decision-making ability in older persons with cognitive impairment. Am J Geriatr Psychiatry. 2008; 16:693–696.
Article
34. Sherod MG, Griffith HR, Copeland J, Belue K, Krzywanski S, Zamrini EY, et al. Neurocognitive predictors of financial capacity across the dementia spectrum: normal aging, mild cognitive impairment, and Alzheimer's disease. J Int Neuropsychol Soc. 2009; 15:258–267.
Article
35. Marson DC, Sawrie SM, Snyder S, McInturff B, Stalvey T, Boothe A, et al. Assessing financial capacity in patients with Alzheimer disease: a conceptual model and prototype instrument. Arch Neurol. 2000; 57:877–884.
Article
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