If your older loved one is showing signs of cognitive decline, it may be time to find out whether they still have “capacity.” This medical term refers to their ability to make decisions while weighing the consequences. It means your relative can understand an issue, appreciate how it applies to them, reason through the options, and express a choice.
Capacity is clinically assessed by a healthcare professional, often one with a background in psychology. In cases of moderate to severe cognitive impairment, a physician may use their own clinical judgment to determine whether someone has capacity. But further evaluation is in order if there is any uncertainty. Or if the older adult struggles with some types of decisions but not others.
When evaluating your relative, the clinician may consider the following:
- Legal standard. What type of capacity is being evaluated, as defined by the law? For example, financial decision making, a safe-driving decision
- Functional elements. What abilities does this type of decision making require?
- Diagnoses. Are any medical or psychiatric conditions affecting those abilities?
- Cognition. What does a cognitive assessment show?
- Emotions. What emotional or psychiatric factors are at play? For example, depression or anxiety
- Values. What does the person value? What are their preferences? How might these considerations influence their decision making?
- Risk. What is at stake in this type of decision?
- Capacity enhancement. Could psychosocial supports improve the person’s ability? A new medication? Occupational therapy?
- Clinical judgment. Considering all factors, does the older adult have the capacity to make this type of decision?
If there are doubts about your relative’s capacity, seek legal counsel from an elderlaw attorney. These professionals can help you with next steps. A clinical assessment of capacity can be used in a larger process of determining whether the older adult is still legally able to make decisions.
Concerned about an aging loved one’s decision-making abilities?
As the Roanoke and Lynchburg experts in family caregiving, we at Gentle Shepherd Hospice work with families who are trying to make sense of changes in a relative and figure out what to do next. Questions about decision-making capacity can be especially difficult because there’s rarely a simple, one-size-fits-all answer. If you’re feeling unsure about what your loved one needs or where to start, we can help you sort through the situation, connect with the right professionals, and build a plan for the best path forward. Give us a call at 1-800-789-0586 (toll-free) to learn more.