Capacity/Competency

Question 1

T or F: Capacity is task-specific

Answer 1

True (and can fluctuate)

Question 2

Name 4 strategies to improve communication with patient with intelectual disabilities

Answer 2

Avoid medical jargon

Assess understanding
Use simple language

Allow extra time

Use visual aids

Involve support person (with consent)

Question 3

Name the hierarchy of the Substitute Decision-Maker (SDM).

Answer 3

Great People Can Sometimes Prefer Real Orderly Ties
G – Guardian (court-appointed)

P – Power of Attorney for personal care

C – Child or parent (custodial parent first)

S – Spouse or partner

P – Parent (if no custody issue)

R – Sibling (Brother/Sister)

O – Other relative

T – Trustee/Public Guardian and Trustee

Question 4

What are the 4 C’s of capacity

Answer 4

Context (situation faced)
Choices (understand the options)
Consequences (understand ramifications)
Consistency (fluctuation)

Question 5

What are the two main components of Capacity?

Answer 5

Understanding and Appreciation

Question 6

Name 3 components of consent

Answer 6

Must be related to treatment
Must be informed
Must be voluntary

Question 7

Name 4 diagnoses that should prompt consideration of impaired capacity.

Answer 7

Dementia

Stroke

Severe mental illness

Head injury

Question 8

Name 4 subtle red flags of cognitive decline.

Answer 8

Family concerns

Medication errors

Repetitive questioning

Decline in personal hygiene

Question 9

If a patient continues to refuse capacity assessment and risk remains, what may be required?

Answer 9

Pursuit of a substitute decision-maker.

Question 10

What professionals might assist in complex capacity assessments? (5)

Answer 10

Psychiatry

Geriatrics

Neuropsychology

Social work

OT