Letter of Competency: What is It and Why Is It Needed?

If you are a caregiver for an elderly family member, you may wonder if you should obtain a letter of competency from the doctor. A physician’s statement of mental competency involves important decisions that are life-altering. It should not be entered into without completely understanding what a physician’s statement of mental incompetence means, and how it will affect your loved one.

There are many factors to consider when it comes to proving incompetence. Losing competency in dementia patients often leads to the need for a physician’s letter of mental incompetence.

It is required by the courts to determine guardianship or conservatorship. Once the doctor’s declaration of incompetence has been filed with the courts, the person who is declared incompetent will have certain rights removed permanently.

Following is a list of things the person will no longer be able to do:

• Consent or deny medical procedures or treatments.
• Sign legal documents.
• Make financial transactions or decisions, such as opening or closing accounts, signing checks, or withdrawing money.
• Deciding where to live.
• In some states, they can’t make the decision to get married.
• Transfer titles to cars, homes, or properties.

As you can see, the doctor’s letter of incompetence ends the individual’s ability to make any legal, medical, personal, or financial decisions.

When your loved one begins to decline to the point you are thinking it is time to act regarding his mental competency, you may have heard of two terms that are often used interchangeably.

Capacity and Competence have slightly different meanings. Simply put, capacity refers to the ability to make decisions. Competency means the person has the mental capacity to perform the actions to put those decisions into effect.

When it comes to a letter of capacity, letter of incapacitation, or medical incapacity letter, these are all different ways to say the same thing. A letter of capacity and a letter of competency are both drawn up and signed by a licensed physician to be presented in court to establish guardianship or conservatorship.

So, what do you look for, and how do you know when it’s time for a trip to the doctor to obtain this important and at the same time, heartbreaking document?

• Difficulty managing activities of daily living, such as bathing, dressing, mouth care, eating, cooking, and keeping house. Looking disheveled, putting underwear on over clothes, inappropriate clothing for the season, such as flip flops in the snow or heavy coat in the summer.
• Failure to make safe decisions. This would include things such as letting strangers in the house, wandering, leaving doors open, getting into car accidents, unexplained dents in the car, authorizing work that doesn’t need to be done, and giving out sensitive information.
• Inability to manage finances. This would include succumbing to scams by giving money away, divulging bank account numbers, scheduling work around the house by scamming handymen and paying in advance, forgetting how to write checks, use debit and credit cards, and failure to keep up with bills.
• Refusing help, not taking medications, refusing doctor visits, or driving when they shouldn’t be.

Some of these instances may sound extreme, but when it involves the person who gave you life, it is extremely difficult to make the decision to have them declared incompetent.

But in our hearts, we know when it’s time. Consult your physician when you know the time has come and they can help you through the process. You can also contact an elder care attorney in your area to assure the documents are complete, legal and will provide the best protection for your loved one.