For any of us, making complicated decisions can be difficult at times. However, for those with severe learning or mental health issues, it can even be more difficult and result in the need for an evaluation of the individual’s capacity for making decisions (formerly known as a “competency” evaluation). In Alberta, either a psychologist or a physician can legally declare someone as not having decision making capacity. A capacity assessment is done only if there are legitimate reasons to believe the adult doesn’t have the ability to make their own decisions.

However, before a capacity assessment is done, a physician must give the adult a check-up to make sure their decision-making ability isn’t being affected by a medical condition that is temporary, or reversible. Once this is done, a healthcare professional called a capacity assessor (such as a psychologist), checks to see if the adult understands:

• the facts they should consider when making a decision
• what could happen if they choose one option over another

Capacity is assessed to help determine whether or not a personal directive should be enacted to give the agent authority to make a personal decision, or whether one of these decision-makers should be appointed for an adult:

• co-decision-maker
• guardian
• trustee

During an adult guardianship and trusteeship capacity assessment, we meet with the adult, ask them questions to determine the degree to which they can make personal decisions, and (if necessary), fill out and signs a form (valid for 6 months) to be used in an application for guardianship or trusteeship. Psychologists have unique skills to determine whether an individual's cognitive, emotional, or developmental condition is interfering with judgment and reasoning, and rendering the individual at risk to themselves or others. Through standardized cognitive and neuropsychological assessment tools, psychologists can provide comprehensive evaluations of thinking and reasoning skills, problem solving, language functioning, attention, memory, and emotional state, in order to make the determination of whether an individual should be declared a dependent adult.