Capacity Toolkit

Checklist Overview

Introduction Purpose Guidance (not legal advice) Definition of capacity Legal test for capacity

Key Practice Points Presumption of capacity Capacity is decision/time specific Assess the ability NOT the decision Supported decision making Substitute decision making Tikanga Māori & cultural diversity Form of assessment Who should carry out assessments

Capacity Assesment Overview Preparing Assesment Interview After the Interview

The Legal Framework Overview Mental capacity law Relevant legal test PPPR Act : capacity thresholds Activating EPOAs HDC Code: capacity to consent to treatment Right 7(4) of the HDC Code Capacity to make a Will Refusal to undergo assessment

Useful Resources Legal resources Education video Cultural competence International guides to assessment Authors & Acknowledgments

GUIDANCE - NOT LEGAL ADVICE

This toolkit does not take the place of legal advice. Where a formal assessment has been requested, the referrer should clarify: the legal test, the particular questions to be answered, and that the clinician has been given all the necessary information to be able to complete the assessment.

People with impaired decision-making capacity may be vulnerable to abuse, coercion and undue influence from others, which may compromise their decisions being made freely and voluntarily. If there is suspicion of undue influence, then consider whether other professionals, or social agencies need to be involved and who can support the person in obtaining that advice. For example, whether the person should obtain independent advice from a lawyer or accountant, or support from Age Concern.

Assessing a person’s decision-making capacity may not be straightforward. Where the decision involves significant risk, or where there is conflict about the decision, it can be difficult to separate incapacity from differing personal values or unwise decisions. In these situations it is a good idea to seek the advice of colleagues and members of the multi-disciplinary team, or where possible, to seek advice from a clinical ethics advisory group.