Photograph of older man who is deliberating about something; photo source: Administration on Aging, DHHS Competency Demonstration

Complex Decisions Competency

Guide older adults and their families/caregivers in making complex decisions that arise with aging.

A competency demonstration provides you with the opportunity to demonstrate that you have developed one or more of the Competencies for Working with Older Adults. Presentation: Competencies for Working with Older Adults

Demonstrate your Complex Decisions Competency by completing one of the following projects. We have provided you with a choice of projects. Choose one project. We do not expect you to do them all! 

If you are using these Older Adult Focus materials for self-study, completing a competency demonstration gives you an end product that you can share with others for professional purposes, such as in a portfolio for employment application or as a demonstration of meeting a professional goal for an annual review. Once you have completed the competency demonstration, wait for at least 3 days and then use the criteria to evaluate your own work. Alternatively, you could ask another person to use the evaluation criteria and discuss your work with you.

If you are using these Older Adult Focus materials as part of an organized course or workshop, consult your course leader regarding how to turn in your completed competency demonstration.

 Picture of pencil and checklist Develop a Case Study

Introduction to Case Studies:

Case studies are a useful way to teach others about situations faced by older adults. Case studies typically have three components:

Some case studies include a bibliography, which allows readers to explore the issues further.

Directions for this Competency Demonstration:

Develop a case study involving a complex decision for an older adult (and family/caregiver if pertinent). To begin, identify a real life case example of a complex decision that involves one of the following:

Write a scenario that describes the situation and the issues that arose for the older adult and family. 

Develop five thought-provoking open-ended questions for the readers. 

Create a facilitator guide for the case study. 

Provide a bibliography of at least five citations from current professional literature (and reliable websites if you wish) related to the topic.


  • Include your scenario (maximum of two pages, double-spaced), questions, facilitator guide (maximum of four pages, double-spaced), and bibliography.
  • Maintain confidentiality by omitting identifying information.
  • Spell-check and proofread your written work. 

For a grade of pass, your demonstration will meet these criteria:

 Picture of pencil and checklist Provide Advance Directives Education to Older Adults

Research indicates that many older adults are interested in expressing their health care preferences in the form of advance directives. Yet, the majority of older adults have not completed these forms. 

Develop and present an education session for older adults that focuses on advance directives. Include time for discussion in your session. Write a summary that includes how you recruited the attendees, the location and date of the presentation, brief description of the session, summary of discussion during the session, and response of the attendees. Include a bibliography of at least five references (professional literature and reliable websites) you used in preparing your education session. 

Write no more than three double-spaced pages of summary. Attach your bibliography and the materials that you used in the education session (e.g., your teaching outline, handouts, PowerPoint presentation). If you have large or bulky audiovisual aids, you can send a photograph or written description of them.


  • Write a maximum of three pages, double-spaced. (Attached bibliography and teaching materials do not count in the three pages.)
  • Maintain confidentiality by omitting identifying information.
  • Spell-check and proofread your written work. 

For a grade of pass, your demonstration will meet these criteria:

  • Documentation includes where, when, and to whom the education session was presented and how the attendees were recruited.
  • Content and level of the education session are appropriate for older adults.
  • Discussion that occurred during the education session indicates engagement with the topic by attendees.
  • Materials used in the education session demonstrate awareness of sensory changes of aging.
  • Bibliography contains at least five current reliable references.
  • The materials do not convey patient identifying information.
  • Spelling, grammar, and punctuation are accurate.

Note: You will find this article useful and may include it in your bibliography after you read it:

Inman, L. (2002). Advance directives: Why community-based older adults do not discuss their wishes. Journal of Gerontological Nursing, 28(9), 40-46.

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