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 http://www.ncat.nsw.gov.au/Pages/guardianship/guardianship.aspx