Assessing capacity
The six step capacity assessment process[1]
1. Identify the reason for assessing capacity
These are generally situations that could place the patient or others at risk if there is a lack of decision making capacity. This may be when a patient wants to:
- make a will;
- grant a power of attorney;
- make an advance care plan;
- manage finances or property;
- choose medical treatment; or
- manage personal care.
2. Engage the person being assessed in the process
- Ensure and document that you have the patients full participation
- Explain context to patient
3. Gather information to describe the context, choices and their consequences
Use collateral information from all available sources in community (family, neighbours, service providers)
4. Educate the person about the context, choices and their consequences
- Explain the available options and their benefits and risks.
- Ask the patient to repeat, in their own words, the information back to you to ensure they understand the information.
5. Assess capacity
Keep in mind that decision making in various domains (health, financial and lifestyle) involves a mixture of cognitive and functional abilities, and a person can be incapable in one domain and capable in another.
6. Take action based on results of the assessment
- Patient has capacity
- Patient does not have capacity
- Patient’s capacity is uncertain
Whatever the outcome of the assessment, keep a careful record of the whole process in the patient's records.
1. Darzins, P., Molloy, D.W. and Strang, D., 2000. Who can decide? The six step capacity assessment process. Glenside, SA: Memory Australia.