PHYSICIAN INPUT INTO GUARDIANSHIP CASES INVOLVING THE ELDERLY

The determination of an elderly person's competence in guardianship de cisions rests primarily on the written statement of an examining physi cian. We evaluated this physician input by retrospectively reviewing 4 0 competency case files of persons over age 60 from the Harris County Probate Courts. Of the 40 physician letters reviewed: 10 (25%) did not include a medical or psychiatric diagnosis; 37 (92.5%) did not includ e results of a formal mental status exam; 19 (47.5%) of the letters we re essentially unsupported statements of incompetence. Finally, 29 (72 .5%) of the cases failed to include a statement on prognosis or potent ial need for reevaluation. The medical information transmitted to the courts in guardianship cases involving the elderly was inadequate for the courts to make informed decisions. Guidelines for evaluation were developed to facilitate the transmission of adequate patient data, and to direct physicians as to what information is needed by the court in making guardianship decisions.