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Marginal Competence, Risk Assessment, and Care Decisions: A Comparison of Values of Health Care Professionals and Older Adults

  • Penny MacCourt (a1) and Holly Tuokko (a1)

Using a case scenario involving a marginally competent elderly woman living alone at risk, we assessed the care decisions made by older adults (n = 82) and health care professionals (HCPs, n = 87), and identified differences in the values underlying the care decisions. Overall, participants did not place a high value on independence when they appraised the risk to the client as high and safety as low. Under these conditions, elderly respondents tended to be more paternalistic in their decisions about care, while HCPs tended to be more beneficent. If the values of HCPs differ from those of elderly people, how likely is it that the care provided to marginally competent elderly people will be congruent with their wishes? The care provided by HCPs might be improved by incorporating knowledge of the values and perspectives of other older adults.


Par l’utilisation d’un scénario impliquant une femme âgée vivant seule compétent marginalement à risque, nous avons évalué les decisions liées aux soins réalisés par les adultes plus âgés (n = 82) et les professionnels de la santé (professionnels de la santé, n = 87), et les différences identifiées dans les valeurs qui sous-tendent les décisions relatives aux soins. Dans l’ensemble, les participants n’ont pas placé une grande valeur à l’independance quand on a évalué les risques pour le client comme plus élevé et la sécurité comme aussi bas. Dans ces conditions, les répondants âgés tendaient à être plus paternaliste dans leurs décisions concernant les soins, tandis que les professionnels de la sante ont tendance à être plus salutaire. Si les valeurs des professionnels de la santé diffèrent de ceux des personnes âgées, quelle est la probabilité que les soins dispensés aux personnes âgées peu compétentes seront conformes à leurs désirs? Les soins donnés par les professionnels de la santé pourrait être ameliorés en y incorporant la connaissance des valeurs et des perspectives des autres adultes âgés.

Corresponding author
*Correspondence concerning this article should be addressed to / La correspondance concernant cet article doit être adressées à: Penny MacCourt, PhD Centre on Aging. University of Victoria Sedgewick Building A104 PO Box 1700 STN CSC Victoria, B.C. V8W 2Y2 (
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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
  • URL: /core/journals/canadian-journal-on-aging-la-revue-canadienne-du-vieillissement
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