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The four key components to address in a capacity evaluation include: 1) communicating a choice, 2) understanding, 3) appreciation, and 4) rationalization/reasoning.
(As described in the MCA code of practice, Chapter 4, these four tasks are: to understand relevant information appropriately presented, retain it for long enough to use and weigh it to docHub a decision, then to communicate by any means possible that decision)The fourth step, inability to communicate, specifically
Four Component Model of Decisional Capacity. Capacity for healthcare is generally defined in terms of four dimensions or criteria: (a) Understanding, (b) Appreciation, (c) Reasoning, and (d) Expression of a Choice (Grisso Appelbaum, 1998a; Roth, Meisel, Lidz, 1977). Assessment of Healthcare Decision-making Capacity - NCBI National Institutes of Health (NIH) (.gov) articles PMC5007079 National Institutes of Health (NIH) (.gov) articles PMC5007079
Principle 4: Best interests Anything done for or on behalf of a person who lacks mental capacity must be done in their best interests. Mental Capacity Act 2005 at a glance - SCIE scie.org.uk mca introduction mental-ca scie.org.uk mca introduction mental-ca
How is mental capacity assessed? The MCA sets out a 2-stage test of capacity: Does the person have an impairment of their mind or brain, whether as a result of an illness, or external factors such as alcohol or drug use? Does the impairment mean the person is unable to make a specific decision when they need to?
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How is mental capacity assessed? understand the information relevant to the decision. retain that information for long enough to make the decision. use or weigh up that information as part of the process of making the decision. communicate their decision in any way. Mental Capacity Act - Social care and support guide - NHS NHS making-decisions-for-someone-else NHS making-decisions-for-someone-else
Outline Understanding. Expressing a choice. Appreciation. Reasoning. Assessment of decision-making capacity in adults - UpToDate Wolters Kluwer contents assessment-of-dec Wolters Kluwer contents assessment-of-dec
In the codes of practice, the people who decide whether or not a person has the capacity to make a particular decision are referred to as assessors. This is not a formal legal title. Assessors can be anyone for example, family members, a care worker, a care service manager, a nurse, a doctor or a social worker.

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