Evaluation of Elderly Persons in the Criminal Justice System

The assessment of the elderly defendant presents a specific set of challenges in the forensic psychiatric evaluation process. In this special population, a neurocognitive disorder or the presence of cognitive, psychiatric, and behavioral symptoms can impair a defendant’s understanding of the legal system or their ability to work effectively with an attorney in the preparation of a defense. Therefore, assessments of capacity to stand trial may require special attention to the mental health conditions and symptoms more commonly seen in elderly persons, and the evaluation process may require modification to accurately assess this population and to rule out malingering. Unique challenges are also encountered in the evaluation of elderly defendants for criminal responsibility and in presentencing evaluations. This chapter provides an overview of these challenges and strategies to promote accurate evaluation of the elderly defendant.