Psychiatric services : a journal of the American Psychiatric Association
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The study determined the rate of incapacity to give informed consent for medical treatment among patients admitted to a nursing home and assessed whether clinical staff members recognized this incapacity and whether they used alternative means to provide surrogate decision making for their patients' treatment. ⋯ The prevalence of incapacity to give informed consent in the nursing home population was high. Clinical screening by staff did not identify all clinically incompetent patients, and staff had unresolved conflicting opinions about individual patients' capacity to give informed consent. Even when staff recognized a patient's incapacity to give informed consent, proper legal procedures for appointing surrogate decision makers were not followed.