Capacity assessment - Revision history

Danbot: Danbot moved page Capacity Assessment to Capacity assessment without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

2026-03-22T05:31:20Z

Danbot moved page Capacity Assessment to Capacity assessment without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

← Older revision	Revision as of 05:31, 22 March 2026
(No difference)

Cole Ettingoff: /* External Links */

2025-06-07T22:25:09Z

External Links

← Older revision		Revision as of 22:25, 7 June 2025
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	==External Links==		==External Links==

	~~MacArthur Capacity Tool (MacCAT~~-T)		[https://www.journalofethics.org/article/aid-capacity-evaluation/2006-11 Aid to Capacity Evaluation (ACE)]

	Aid to Capacity Evaluation (ACE)

	~~American Bar Association: Capacity Assessment Guidelines~~

			[https://www.americanbar.org/groups/law_aging/resources/capacity_assessment/ American Bar Association: Capacity Assessment Guidelines]

	==References==		==References==
	<references/>		<references/>

Cole Ettingoff: /* See Also */

2025-06-07T22:21:50Z

Cole Ettingoff: /* Management */

2025-06-07T22:20:48Z

Management

← Older revision		Revision as of 22:20, 7 June 2025
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	If the patient lacks capacity:		If the patient lacks capacity:

	Identify appropriate surrogate decision-maker (per legal hierarchy)		* Identify appropriate surrogate decision-maker (per legal hierarchy)
			*
	Consider temporary holds or guardianship if no surrogate is available		* Consider temporary holds or guardianship if no surrogate is available
			*
	Treat reversible impairments and reassess		* Treat reversible impairments and reassess
			*
	Ensure decisions are patient-centered, honoring prior expressed wishes or advance directives		* Ensure decisions are patient-centered, honoring prior expressed wishes or advance directives
			*
	Involve ethics consultation if disputes arise		* Involve ethics consultation if disputes arise

	==Disposition==		==Disposition==

Cole Ettingoff: /* Workup */

2025-06-07T22:19:58Z

Workup

← Older revision		Revision as of 22:19, 7 June 2025
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	# Understanding: Can the patient explain the condition and options?		# Understanding: Can the patient explain the condition and options?

	# Appreciation: Does the patient recognize how the information applies to their situation?		# Appreciation: Does the patient recognize how the information applies to their situation?

	# Reasoning: Can the patient compare risks/benefits and explain their choice?		# Reasoning: Can the patient compare risks/benefits and explain their choice?

	# Communication: Can the patient clearly express a stable choice?		# Communication: Can the patient clearly express a stable choice?

	Assess for reversible causes (e.g., hypoxia, infection, intoxication)		Assess for reversible causes (e.g., [[Hypoxemia\|hypoxia]], infection, intoxication)

	Use structured tools if needed: MacCAT-T (MacArthur Competence Assessment Tool for Treatment), Aid to Capacity Evaluation (ACE)		Use structured tools if needed: MacCAT-T (MacArthur Competence Assessment Tool for Treatment), Aid to Capacity Evaluation (ACE)

Cole Ettingoff: /* Workup */

2025-06-07T22:19:21Z

Workup

← Older revision		Revision as of 22:19, 7 June 2025
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	Clinical interview focused on the four key elements of capacity:		Clinical interview focused on the four key elements of capacity:

	Understanding: Can the patient explain the condition and options?		# Understanding: Can the patient explain the condition and options?

	Appreciation: Does the patient recognize how the information applies to their situation?		# Appreciation: Does the patient recognize how the information applies to their situation?

	Reasoning: Can the patient compare risks/benefits and explain their choice?		# Reasoning: Can the patient compare risks/benefits and explain their choice?

	Communication: Can the patient clearly express a stable choice?		# Communication: Can the patient clearly express a stable choice?

	Assess for reversible causes (e.g., hypoxia, infection, intoxication)		Assess for reversible causes (e.g., hypoxia, infection, intoxication)

Cole Ettingoff: /* Differential Diagnosis */

2025-06-07T22:18:41Z

Differential Diagnosis

← Older revision		Revision as of 22:18, 7 June 2025
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	==Differential Diagnosis==		==Differential Diagnosis==

	Delirium (often reversible and acute)		[[Delirium]] (often reversible and acute)

	Dementia (usually progressive and chronic)		[[Dementia]] (usually progressive and chronic)

	Psychiatric illness (e.g., psychosis, depression)		Psychiatric illness (e.g., [[Acute psychosis\|psychosis]], [[Depression\|depression]])

	Intellectual disability		Intellectual disability

	Aphasia or language barriers		[[Aphasia]] or language barriers

	Influence of medications, intoxication, or metabolic derangements		Influence of medications, intoxication, or metabolic derangements

Cole Ettingoff: Created page with "==Background== Capacity refers to a patient’s ability to understand, appreciate, and make informed decisions about their medical care. It is decision-specific and time-specific, meaning a patient may have capacity for one decision but not another, or may regain capacity later. Unlike competence, which is a legal determination, capacity is a clinical judgment made by healthcare professionals. ==Clinical Features== Features indicating possible impaired capacity include:..."

2025-06-07T22:11:32Z

Created page with "==Background== Capacity refers to a patient’s ability to understand, appreciate, and make informed decisions about their medical care. It is decision-specific and time-specific, meaning a patient may have capacity for one decision but not another, or may regain capacity later. Unlike competence, which is a legal determination, capacity is a clinical judgment made by healthcare professionals. ==Clinical Features== Features indicating possible impaired capacity include:..."

New page

==Background==
Capacity refers to a patient’s ability to understand, appreciate, and make informed decisions about their medical care. It is decision-specific and time-specific, meaning a patient may have capacity for one decision but not another, or may regain capacity later. Unlike competence, which is a legal determination, capacity is a clinical judgment made by healthcare professionals.

==Clinical Features==
Features indicating possible impaired capacity include:

Confusion, disorientation

Delusions or hallucinations

Expressing choices inconsistent with known values

Inability to explain the nature or consequences of decisions

Fluctuating mental status or consciousness

==Differential Diagnosis==

Delirium (often reversible and acute)

Dementia (usually progressive and chronic)

Psychiatric illness (e.g., psychosis, depression)

Intellectual disability

Aphasia or language barriers

Influence of medications, intoxication, or metabolic derangements

==Evaluation==

===Workup===

Clinical interview focused on the four key elements of capacity:

Understanding: Can the patient explain the condition and options?

Appreciation: Does the patient recognize how the information applies to their situation?

Reasoning: Can the patient compare risks/benefits and explain their choice?

Communication: Can the patient clearly express a stable choice?

Assess for reversible causes (e.g., hypoxia, infection, intoxication)

Use structured tools if needed: MacCAT-T (MacArthur Competence Assessment Tool for Treatment), Aid to Capacity Evaluation (ACE)

Consult psychiatry if unclear or complex

===Diagnosis===
Capacity is not all-or-none and should be judged relative to the complexity and risk of the decision. A patient with mild cognitive impairment may still have capacity for low-risk decisions. Document reasoning and patient responses thoroughly.

==Management==

If the patient lacks capacity:

Identify appropriate surrogate decision-maker (per legal hierarchy)

Consider temporary holds or guardianship if no surrogate is available

Treat reversible impairments and reassess

Ensure decisions are patient-centered, honoring prior expressed wishes or advance directives

Involve ethics consultation if disputes arise

==Disposition==

If capacity is regained, defer major decisions until reassessment

If patient lacks capacity and is at risk, consider admission or legal measures for protection

Ensure continuity of care planning with healthcare proxy or legal guardian

==See Also==

Informed Consent

Delirium

Guardianship

Ethics Consultation

==External Links==

MacArthur Capacity Tool (MacCAT-T)

Aid to Capacity Evaluation (ACE)

American Bar Association: Capacity Assessment Guidelines

==References==
<references/>

← Older revision		Revision as of 22:21, 7 June 2025
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	==See Also==		==See Also==

	Informed Consent		[[Informed Consent]]

	Delirium		[[Delirium]]

	Guardianship		[[Guardianship]]

	~~Ethics Consultation~~

	==External Links==		==External Links==