Decision Making Capacity and Cognitive Impairment

Determining whether or not an individual has the ability (capacity) to make important lifestyle or financial decisions is a complex one.  When we refer to Decision Making Capacity, we are generally referring to an individuals ability to:

  • Make decisions regarding where they live.
  • Make decisions regarding what medication they take or what medical treatment they receive.
  • Make decisions regarding whether or not they accept particular services into their home to assist them (e.g. HomeCare / cleaning / meals on wheels).
  • Manage their own finances
  • Write a will
  • Enter into a contract or deed
  • Execute or appoint a Power of Attorney
  • Appoint an Enduring Guardian

An individual's ability to make decisions can be affected by various neurological and psychiatric conditions, for example:

  • Dementia
  • Stroke
  • Brain Injury
  • Neurological Conditions
  • Psychiatric Illnesses (e.g. Schizophrenia)

Capacity is not a unitary concept, that is, it is certainly not an all or none decision.  For example, an individual may be deemed unable to make decisions regarding their financial management but they are still capable of deciding what medication to take.  In regards to an individuals level of cognitive functioning, the more complex the decision that is required to be made, the higher the level of cognitive functioning that is required.  

A neuropsychological assessment (cognitive assessment) is a comprehensive assessment that looks at an individuals mental state and level of cognitive functioning.  A neuropsychological assessment is of great value in determining whether or not an individual has the level of cognitive functioning to make the necessary decisions and will take into account the level of complexity of the decisions that are being made.  Neuropsychological assessment are used as evidence at the NSW Civil and Administrative Tribunal - Guardianship Division (NCAT), by solicitors and in court proceedings in determining an individual's decision making capacity.  

If you have any questions regarding the neuropsychological assessment of capacity, please contact us to discuss further.

For further information regarding the NSW Guardianship Division see

Traumatic Brain Injury

Traumatic Brain Injury often leads to a variety of complex cognitive difficulties that can impact on a person's ability to return to their previous vocational, domestic and social roles. The degree that it affects someone in these areas can vary widely, and depends on the severity of their injury (i.e. mild, moderate or severe), type of cognitive impairment, and whether any behavioural or emotional difficulties also exist. A person's cognitive and psychological adjustment to a traumatic brain injury is best helped in the early stages of the injury, to assist in educating the person and family as to the effects of the injury, and providing strategies and psychological support throughout their recovery.

Neuropsychological assessments are currently the best practice in cognitive assessment, and can provide the best indicator of a person's ability to return to work and other life roles (e.g. parenting, financial management, domestic duties etc.). They are also used to determine the longer term cognitive effects of a traumatic brain injury in medicolegal compensation cases.

Current changes to the NSW Greenslip structure now incorporates a levy to provide lifetime care for those seriously injured in a motor vehicle accident, and who require longer term care. For details relating to the lifetime care and support authority, eligibility criteria, and services that are funded, please visit:

Please do not hesitate to contact us for free initial advice in relation to any queries surrounding traumatic brain injury and cognitive, behavioural or psychological difficulties.

Alzheimer's Disease

Dementia is becoming an increasingly common condition in our aging population here in Australia. When we think of Dementia we often automatically think of Alzheimer's Disease, however there are many different types of dementia or other conditions that can cause dementia like symptoms. Alzheimer's Disease although is by far the most common type of dementia.  However it is not always the case that everyday cognitive problems, such as memory difficulties, are due to neurodegenerative conditions.  Neuropsychological assessments can help clarify whether these cognitive concerns are due to Dementia / other potential factors or simply due to natural age related cognitive decline 

If you are concerned about cognitive decline we would recommend you visit the Alzheimer's Australia website below for general information on the link below or contact us at no cost to discuss your concerns.