==== Front Innov Aging Innov Aging innovateage Innovation in Aging 2399-5300 Oxford University Press US 10.1093/geroni/igaa057.147 igaa057.147 Abstracts Session 2849 (Poster) Elder Mistreatment: Prevention, Programs, Practice, and Policy AcademicSubjects/SOC02600 An Orphan Needing a Champion–Barriers to Evaluations of Decision-Making Capacity Factora Ronan Saxena Saket Cleveland Clinic, Cleveland, Ohio, United States 2020 16 12 2020 16 12 2020 4 Suppl 1 Program Abstracts from The GSA 2020 Annual Scientific Meeting “Turning 75: Why Age Matters”45 45 © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.2020This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Abstract Impaired decision making capacity is common in medical and community settings, often coexistent with functional impairment and dementia. Though the legal system determines competence, deciding if guardianship is appropriate often relies on a medical assessment of decision making capacity. Physicians conduct cognitive evaluations but are often unaware of a person’s functional impairments and are unfamiliar with their role in pursuing guardianship. Despite the individual roles of the legal system, medical system, and community agencies (e.g. Adult Protective Services (APS)) in such cases, no agency claims responsibility for ensuring this process’s fidelity. As numbers of older citizens in the US increase along with associated increasing numbers of cases involving impaired decision making capacity, ensuring this processes’ fidelity is essential. We sought to identify the barriers (recognized by each of these parties) in determining decision making capacity of persons for whom guardianship is being considered. Surveys were conducted with professionals in the legal, medical, and APS arenas, to identify barriers to obtaining capacity determinations. Common themes identified amongst these entities included needing to include functional status in this evaluation, and the need for clear communication between the legal system, medical system, and APS. Unique concerns identified in the survey included APS caseworkers challenges in finding physicians willing to complete capacity evaluations, judges’ concerns about evaluations’ failure to address safety issues and need for immediate action , and physician’s concerns about liability and compromising the physician-patient relationship. Continued collaboration between these systems could overcome these barriers.