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Competency is a complex issue that is best considered while the individual is still competent. If a trusted child or friend or business can be entrusted with the future responsibility of finances or personal health of an individual while that individual can take an active or directive part in the decision, the outcome can be smooth. The actual declaration of incompetency and the legal ramifications are then part of a long term plan that can be initiated as needed.

However, it is common that the competency issue is raised after the individual's world has started to come apart. This is perceived at two levels: financial and personal health. Standard Mental Status Examinations can be used to obtain some of the information required to determine these two competencies but often additional information is required by the Office of the Public Trustee and ultimately by the court to confirm incompetence and assign committee. The standard tests and forms can deal relatively simply with issues of orientation, memory impairment, decreased mentation and ability to do mathematics. The issues of impaired insight and judgement and abnormal mood are more difficult and often require attestation by two physicians.

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