EVALUATING THE CAREGIVERS INTERVENTION IN THE ELDERS TASK-PERFORMANCE- CAPACITY VERSUS ACTUAL BEHAVIOR

As an elder's functional impairment increases, so in general does the tendency for the caregiver to intervene in the elder's daily activitie s and initiatives. To a certain extent, such intervention is necessary to compensate for the elder's loss of independent ability, and withou t such intervention, adverse outcomes for the elder are a possibility. The need for some intervention is usually clear-cut for advanced deme ntia, given its associated severe disability and handicap, but less cl ear in elders who are just beginning to show signs of cognitive declin e. This study used the paradigm of medication management to look at wh ether the discrepancy between capacity for self-medication administrat ion and actual self-administration behavior as demonstrated by the Med ication Management Test (MMT) is greater for elders with poorer cognit ive functioning. A sample of 51 cognitively impaired elders and 74 cog nitively normal elders was used to look at the relationship between pr edicted capacity and actual self-administration of medication, stratif ying by level of cognitive status. The highly significant concordance between the MMT score and caregivers' report of medication administrat ion supports the expectation that capacity is influenced by cognitive status. In those discordant cases, further information is needed to in terpret help in medication administration as excessive or insufficient intervention. (C) 1997 John Wiley & Sons, Ltd.