Say the phrase ‘mental capacity assessment’ and most people feel a sense of dread and foreboding but that shouldn’t be the case. Tim Farmer, the UK’s foremost expert in the assessment of mental capacity, explains why it should be seen as a good thing.
What is the purpose of an assessment?
Contrary to popular belief, the purpose of an assessment is not to trick you or to find fault. An assessment should attempt to show you at your best. Arguably, the real purpose of an assessment is to provide you with a solution. To help identify what you can and cannot do as part of the decision making process and allow you, a professional or a family member to make an informed decision as to what the next possible steps are.
What is ‘mental capacity’?
Mental capacity is simply another way of saying “A person’s ability to make a decision”. Decisions relating to Lasting Powers of Attorney (LPAs), financial affairs, treatment and welfare are governed by The Mental Capacity Act (2005). The Act itself outlines five key principles and provides us with an assessment framework which is commonly referred to as ‘The 2 stage test’.
Capacity is time and item specific
It is important to be aware that mental capacity is item specific. This means that a person may have the ability to make a decision about what clothes to wear but they may not be able to make decisions about how they spend their money.
It is also important to note that capacity is time specific. We know people present differently at different times. For example a person might be better able to make decisions in the morning. That is why it is important that you let an assessor know if you or your loved one has a better time of day or if they have an infection or illness that is affecting the way you or they think.
Where and how will I be assessed?
An assessor should arrange to meet with you at a time and place that is most convenient to you. They will probably want to meet with you on a one-to-one basis but that doesn’t mean you can’t have someone you know with you but you will probably just need to arrange this in advance with the assessor.
In line with the Mental Capacity Act (2005) and the 2 stage test the assessor will first check to see if you have any impairment that affects how your brain or mind works and your ability to make a decision – for example dementia. If there is such an impairment the assessor will then check four main areas relating to the decision being addressed. These are
1) That you understand relevant information relating to the decision.
2) That you can retain that information for the duration of the decision making process.
3) That you can weigh up and use relevant information as part of the decision making process.
4) That you can communicate your thoughts and wishes back to them – either verbally or non-verbally.
What sort of questions will I be asked?
You should not be asked to count backwards from 100 in 7’s or draw crazy shapes or even remember when the war started and finished as these sorts of questions are not going to be relevant to the decision in question.
If you are in any doubt as to the information that the assessor requires just ask them. They have a duty to help you demonstrate your best abilities and this is all part of it.
Who can assess mental capacity?
In theory, anyone with relevant expertise can assess mental capacity but they will usually be from a health or social work background for example, doctor, nurse or social worker. The important thing is not their qualification but their experience. Don’t be afraid to ask them about this before booking an assessment.
The process of a mental capacity assessment should not be daunting. Instead it should be a relaxed ‘fact-finding’ session that is done at a place and time that suits you. Its purpose is to help you demonstrate your best level of functioning and then to provide you with an outcome that enables you to move forward with whichever decision you are attempting to address.
Still unsure whether you or a loved one needs an assessment?
If you answer yes to any of the below questions, it’s best to have one done.
1) Do you, or your loved one, have a diagnosis of dementia or Alzheimer’s?
2) Do you, or your loved one, struggle to remember things?
3) Do you, or your loved one, often struggle to understand new and complex information?
4) Is your, or your loved ones, decision likely to be challenged?
5) Are other people worried about your or your loved ones ability to make a decision?
6) Has there been a noticeable change in your or your loved ones cognitive abilities (either suddenly or over time?
About the author
Tim Farmer is the founder and managing director of TSF Consultants the UK’s leading provider of mental capacity assessments to the legal and financial sectors. He is the author of the Amazon international best seller ‘Grandpa on a skateboard; the practicalities of assessing mental capacity and unwise decisions’. He was also named as Expert Witness 2016 (mental capacity) by Lawyer Monthly magazine.
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