You have made sure all of Mom’s legal paperwork is taken care of. Or have you?

Yes, you have a will, documentation of Power of Attorney, Advance Directives, and Healthcare Proxies, but do you have a Letter of Competency? Without it, these other documents may be subject to dispute.

Bitter arguments can arise between family members about what their loved one really wanted, especially if they had dementia or other cognitive impairments. One family member might feel that Mom was unfairly influenced — or was mentally incompetent —when executing these important documents.

What Is a Letter of Competency?

A Letter of Competency is a statement that Mom is “of sound mind” at the time she made decisions. The best times to seek a Letter of Competency is when documents are being drawn up and when they are being changed.

Generally speaking, the best person to write this letter, which attests to the person’s mental capacity to make medical, financial, and legal decisions on their own behalf, is a primary care provider who has known the older person over the course of many years, and is familiar with any changes in their cognition, and their mental and physical health.

However, if Mom is already cognitively impaired, it might be best for a neurologist or a psychiatrist to conduct a thorough mental evaluation.

What is in a Letter of Competency?

The Letter of Competency should include the following:

  • The patient’s name and date of birth
  • The date the doctor first began seeing the patient
  • A statement from the doctor testifying about the patient ‘s ability to make legal decisions, including decisions regarding their medical care and their finances
  • A list of all the patient’s medical diagnoses, with the date of diagnosis for each condition
  • The letter should be written on the physician’s letterhead, and include the doctor’s contact information

Although the Letter of Competency is written by a doctor, it is wise to have a lawyer look it over.

The original letter should be filed with all other legal documents, with a copy kept in the patient’s medical file.

When families clash over an older relative’s documents, it can lead to long-lasting resentments. Prevention, as always, is the best medicine. The Letter of Competency is an easy way for the family to agree that Mom’s wishes were met.

We at Beacon of LIFE, a government-approved PACE program in Oceanport, NJ, know everything about keeping a senior happy and healthy, and ensuring all their needs are met.

Read our reviews on,, and to hear what our residents and their families have to say.

Beacon of LIFE maintains an interdisciplinary team of professionals who give each client the coordinated care they need. Our staff specialize in working with older people, and work with each client and their family to develop the most effective plan of care.

We provide a variety of services, including primary care, hospital care, medical specialty services, prescription drugs, nursing home care, emergency services, home care, physical therapy, occupational therapy, adult day care, recreational therapy, meals, dentistry, nutritional counseling, social services, laboratory / X-ray services, social work counseling, and transportation.

Our care and services allow people who would otherwise need to live in a nursing home to live where they want — in their own communities, in their own homes.

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