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Abstract
Objectives
This study investigated the attitudes of a provincial population towards wills of individuals with dementia and related concerns to prevent civil disputes related to dementia in an aging society.
Methods
The target population was registered residents in a province aged 19 years or older. The population forming the sampling frame was 1478821 (as of May 31, 2013). With a confidence interval of 2% and significance level of 5%, 2540 participants were sampled. This survey used a structured questionnaire composed of two main parts : seven items of general information (sex, age, residence, marital status, education, occupation, and income) and Testamentary Capacity-Related Questionnaire-12 items (TCRQ-12) comprising four items of basic knowledge and eight items of specific situational questions, using a five point Likert scale.
Results
The respondents were favorable toward the guarantee of will-making capacity of individuals with dementia. Self-relatedness, disadvantageousness and undue influence are significantly associated with objection to the will of individuals with dementia. In the pre-evaluation of testamentary capacity of individuals with dementia, the respondents responded strongly and with more favorable attitudes for evaluation by medical specialists than by lawyers. Last, in acceptance of the denial of self-related will due to dementia, negative response was dominant over positive response.
Figures and Tables
Fig. 1
Attitudes towards the restriction or guarantee of the will-making capacity of individuals with dementia. The boxplots in the figure show response distribution for the comparison between Question No. 5 and 6. The respondents showed relatively favorable attitudes for the guarantee of will-making or testamentary capacity of individuals with dementia [restriction although mild, 2.80 (1.07) vs. guarantee although severe, 3.13 (1.06); paired t-test, t=-11.27, p<0.001].
Fig. 2
Attitudes towards objection to the will of individuals with dementia due to related factors. The boxplots in the figure show the comparison among Question No. 7, 8, and 9. Self-relatedness, disadvantageousness and undue influence are significant factors contributing to objection to the will of individuals with dementia [objection just for dementia (a), 3.11 (1.02) vs. objection due to disadvantageousness (b), 3.23 (1.04) vs. objection due to disadvantageousness and undue influence (c), 3.39 (1.13); ANOVA, F=86.44, p<0.001; post hoc analysis (Scheffe), a<b<c].
Fig. 3
Attitudes towards professional pre-assessment of testamentary capacity of individuals with dementia. The boxplots in the figure shows the response distribution for the comparison between Question No. 10 and 11. The respondents showed responses more favorable for the evaluation by medical specialists than by lawyers [lawyers, 3.31 (1.13) vs. medical specialists, 3.40 (1.10); paired t-test, t=-4.92, p<0.001].
Table 3
Factors contributing qualitative change in response to question 9 of TCRQ-12*
*: Logistic regression analysis was used. Qualitative change means change from negative responses ('very much not' and 'considerably not') to positive responses ('considerably yes' and 'very much yes') in Question 9 (I will raise an objection to the will when my father or mother with dementia made a will and unduly influenced by other people, and it is disadvantageous to me). Female, older age and higher educational level were significant factors contributing to the higher objection. The statistic showed that the model adopted in this analysis was significant (Cox & Snell R2=0.024, Nagelkerke R2=0.034; X2=39.020, p<0.001), † : Coefficient of regression, ‡ : Odd ratios. TCRQ-12 : Testamentary Capacity-Related Questionnaire-12 items, S.E. : Standard error
Acknowledgments
This research was supported by the budget of Jeonbuk Dementia Center (2013), Jeollabuk-do, Republic of Korea.
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