Capacity Assessments

As we age, or when navigating complex neurological conditions like dementia, questions regarding “capacity” often arise. In the Australian medical and legal landscape, capacity is a decision-specific and time-specific concept. It is not an “all or nothing” status, but a nuanced evaluation of a person’s ability to make specific decisions at a specific time.

Our geriatricians provide expert, independent, and compassionate capacity assessments to support patients, their families, and legal professionals.

What is a Capacity Assessment?

A capacity assessment is a formal evaluation conducted by a specialist geriatrician to determine if an individual can:

  1. Understand the information relevant to a specific decision.
  2. Retain that information long enough to make the decision.
  3. Weigh or use that information as part of the decision-making process.
  4. Communicate their decision (by speech, gesture, or other means).

 

The Presumption of Capacity

We operate under the fundamental principle that every adult has the right to make their own decisions and is presumed to have the capacity to do so unless proven otherwise. Our role is to provide a clinical evidence base when that presumption is challenged by illness or cognitive decline.

Types of Assessments We Provide

We offer specialised assessments tailored to different legal and personal requirements across Australia:

  1. Financial and Property Management

Assessing whether an individual can manage their own banking, assets, and complex financial affairs. This is often required for the activation of an Enduring Power of Attorney (EPOA).

  1. Testamentary Capacity (Wills)

Evaluations based on the “Banks v Goodfellow” criteria to determine if an individual has the mental clarity to make or change a Will. We assess whether the person understands the nature of the act, the extent of their property, and the claims of those who might expect to benefit.

  1. Medical and Lifestyle Decisions

Determining capacity for an individual to provide informed consent for medical treatments or to make decisions about where they live (e.g., transitioning to Residential Aged Care). This often involves the activation of an Enduring Guardian.

  1. NCAT/VCAT/QCAT Support

Providing independent expert reports for state-based civil and administrative tribunals regarding applications for Guardianship or Administration orders.

Our Process

Our assessments are conducted with the utmost sensitivity, ensuring the patient feels comfortable and respected throughout.

  1. Initial Briefing: We review the referral from a GP, solicitor, or family member to understand the specific “test” required (e.g., is it for a Will or a Power of Attorney?).
  2. Clinical Review: A thorough review of medical history, current medications, and any existing cognitive screening results.
  3. The Interview: A face-to-face (or via Telehealth where appropriate) clinical interview. We use standardised cognitive tools while focusing on the functional decision at hand.
  4. Comprehensive Reporting: We provide a detailed written report that outlines the clinical findings and offers a clear opinion on capacity according to the relevant legal thresholds.

Why Choose a Geriatrician for Capacity?

While many health professionals can perform basic screenings, geriatricians are uniquely qualified because:

  • Complex Comorbidities: We understand how physical illness, polypharmacy (multiple medications), and delirium can temporarily mask a person’s true capacity.
  • Dementia Expertise: We can distinguish between simple memory loss and the executive dysfunction that impacts decision-making.
  • Objective Independence: Our reports are impartial, clinical, and designed to stand up to legal scrutiny.

Frequently Asked Questions

Is capacity permanent? No. Capacity can fluctuate. A person may lack capacity during a hospital stay due to acute infection (delirium) but regain it once they have recovered.

Can a person with dementia still have capacity? Yes. A diagnosis of dementia does not automatically mean a person lacks capacity. Many people in the early stages of cognitive decline are perfectly capable of making significant legal and financial decisions.

How do I book an assessment? Assessments usually require a referral from a General Practitioner. We also welcome enquiries from legal firms seeking independent expert witness reports.