Affiliations: [a] Rehabilitation Institute of Michigan, Wayne State University, 261 Mack Boulevard, Detroit, Michigan 48201, USA | [b] Private Practice, 30161 Southfield Road, Suite 110, Southfield, Michigan 48076, USA
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Corresponding author.
Note: [1] Portions of this manuscript are based on a paper presented at the 101st Annual Meeting of the American Psychological Association, Toronto Canada, August 24, 1993. Preparation of this work was supported, in part by grant #H133A20016 from the National Institute on Disability and Rehabilitation Research.
Abstract: The evaluation of competency in an individual with acquired brain injury has become an area of increasing concern to health care professionals in recent years. The evolving neurobehavioral status, nature and extent of diminished cognition and the post-discharge environment are factors which must be considered when assessing the competency of a person with brain injury to function independently in the community. In addition, clinicians must be familiar with the distinctions between various definitions and models of competency. In most rehabilitation settings, competency to consent to treatment, care for self and property and manage financial affairs are the issues most commonly observed. In the case of acquired brain injury, clinicians are well-advised to maximize a patient's autonomy and avoid a paternalistic stance, whenever possible. Treatment of the patient and family should be directed toward developing compensatory behaviours to allow for safe and successful community reintegration with as much dignity and autonomy as possible.
