It is useful to think of the process of assessing capacity as consisting of three stages:

  • Preparing for the assessment: What is the decision to be made, why is the person’s capacity in doubt, is there a reversible cause for the incapacity, or is the incapacity due to a permanent or progressive condition? Usually there will need to be some contact with family members or other professionals involved in the person’s affairs at this stage to clarify these issues, especially where the person being assessed suffers from dementia and the assessment is more heavily reliant on collateral information. It may also be useful to involve a supportive family member or friend to assist the person in getting to the assessment. This stage of the process is particularly important if there is any question of undue influence or financial abuse, as it will be vital to obtain a history from a range of people to ensure the reliability of the information.

  • The assessment interview: Attention needs to be paid to engaging the person. There needs to be a brief review of the person’s health, mental state and cognition, and the clinician needs to assess the four abilities central to the functional test to capacity.
  • Actions following the interview: These can include a second assessment interview to assess the consistency of the person’s decision making, referral for review of a medical condition, feedback to the person and family, recording the assessment and/or or completion of a report or legal certificate.


  © 2020 Alison Douglass