Capacity

Question 1

What is mental capacity?

Answer 1

The ability to make a decision at a specific point in time

Question 2

Who can assess capacity?

Answer 2

Any doctor

Question 3

At the start, you must always assume….

Answer 3

They have capacity

Question 4

Why would we assess someone’s mental capacity in hospital

Answer 4

To assess whether they have the ability to make informed decisions about their treatment and care

Question 5

Describe the two stage mental capacity test

Answer 5

Firstly, the mental capacity assessment is decision specific e.g. you would do it for ‘do they have capacity to make decision about pressure relieving care’ and it is time specific e.g. it needs to be reassessed each time a decision is required to be made. For example if you think their condition might change you must re-do the MCA.

Stage 1: Is there an impairment of or disturbance of function in a persons mind or brain: yes or no

Stage 2: Is the impairment sufficient to constitute loss of capacity. Stage 2 has 4 components:

• Can the patient understand the information required to make the decision?
• Can they retain the information long enough to make decision?
• Can they weight up information?
• Can they communicate decision back

*Every effort must be taken to communicate, including verbal & non-verbal strategies. Specialist support form SLT or interpretors may be required. Must provide reason for each.

Question 6

State the 5 main principles underpinning the MCA

Answer 6

• Assume capacity until proven otherwise
• Take all practical steps to help a person in decision making
• A person is allowed to make unwise decisions
• Always act or take decision for people without capacity in their best interest
• Consider whether the outcome could be achieved in a less restrictive way