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January 22, 2018: Dr. Arlin Pachet, Capacity Assessment and Rehabilitation     www.PachetServices.com

Dr. Arlin Pachet was introduced by President Ben.

Dr Pachet is a Ph.D, R. Psych, ABPP and a Board Certified Clinical Neuropsychologist. He has conducted over 250 capacity assessments. He conducts workshops, provides expert testimony, and is a teacher of the teachers on this subject. His topic today is "Legal Determinations of Capacity". A very interesting topic it was, and generated many questions from our membership.

The recording of this subject matter tested my capacity. Therefore, Dr Pachet's slideshow containing his speaking notes and contact detail information for your perusal are attached here. (Please note that in the meeting we got to slide 11 with some overlap forward into the materials and Q& A during the presentation. Contact info is on the final slide.) The facts are much better than any interpretation of the facts that I may have perceived!

In Dr Pachet's presentation, he used a case study.

The case presented was that of an 82-year-old gentleman he called Paul, who had lost his wife about three years prior. Paul was presenting medically with a deteriorating progressive dementia, most likely Alzheimer's. He has two daughters and had requested to change his will and power of attorney. He is also quite wealthy. The questions presented and requiring expert input for the lawyers that were referred him for a capacity assessment are:

  • Does he (Paul) have the capacity to change these legal documents now as opposed to 18 months ago, when he changed his will?
  • Did he have the capacity to do so?

Dr Pachet notes that something is unsavoury in this case, but what is it? Paul no longer confides in his daughters, and he has a new love interest in his life. The nature of dementia is that it can negatively affect relationships. Patients develop paranoia.

Dr Pachet believes that the legislation around assessment must be clearer and lobbied for a change, which would include the definition of capacity assessment initiation and follow-through of individuals with their actions.

Alberta did not want to be different from other provinces and quashed the request for the additional wording. Dr Pachet believes that capacity should be assessed on a continuum. Assessment by nature is a bit subjective. Is Paul capable of changing his power of attorney, but not his will? Change of power of attorney has a lower standard regarding capacity assessment. Assent, as opposed to consent! What is the difference? Is there cognitive impairment? The quantum of decision also affects the assessment. The changing of a will is not simplistic! Informed consent is very important.

The Adult Guardian and Trusteeship Guideline are available on line if you are interested at www.HumanServices.Alberta.ca.

Back to the capacity assessment and Paul. Dr Pachet noted the assessment must include information such as:

  • Who made the appointment?
  • Who drove Paul to the office?
  • Who is at the assessment, and who is answering the questions?
  • Is there inconsistency in the answers?
  • Are there any cognitive and neuro changes?
  • Is there a change in behaviour?
  • Is there paranoia?
  • Is there a change in risk tolerance?
  • What is the date? This seems a simple question, but is Paul able to follow through to find the right answer?
  • What is the reason Paul wants to change the will? Paul loves Grace, his new love interest.

Private investigators provide valuable information. How does a financial advisor deal with decisions from a consent perspective? The size of the risk is great at $8.4 million! The advisor attempted a family meeting, but Paul would not give consent. Does the financial advisor refuse to act anymore? What are the significant triggers? Is the love interest coaching? Time to question the motives of the request for capacity assessment.

Dr Pachet must be guided by the legal test. The law criteria were written in 1874. They are excellent and still pertinent.

The outcome of Paul's case: he was able to change his power of attorney, but he was not able to change his will. The changes he made 18 months ago remain unchanged. The daughters' lawyers were able to stop the movement of money from accounts.

Dr Pachet's message to all was to hold the attorney to account. Any interested party can ask for this. If anyone sees possible abuse, any interested person, family doctor, a neighbour or a friend, can ask for this, since it is a self-administrated system.

Thanking the speaker was head table guest, Jonathan Ng. Jonathan thanked Dr Pachet for his respected advice and presented him with the Calgary West Rotary Boltman.

  • Jonathan Ng, Arlin Pachet, and Ben Kormos Jonathan Ng, Arlin Pachet, and Ben Kormos

reported by Marie Rickard

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