Capacity Assessment

Prescribers (physicians, psychologists, nurse practitioners and others) may be called upon to assess a patient's capacity to participate in one or more types of decision-making. There are different capacities. One standard can apply to decisions about whether to accept a potentially uncomfortable procedure. A different capacity threshold may relate to decisions about financial matters, and yet another to decisions about where to live and with whom.

Connect Care provides prescribers with tools to facilitate the assessment and documentation of patients' decision-making capacity; these are outlined here. However, there remain some Alberta Government forms that must dealt with outside of Connect Care and then scanned or attached to the "Media" tab within a patient's chart.

Resources

• • Guideline: Cognitive Impairment (Toward Optimized Practice, Alberta)

  • Guide: Functional Cognition

  • Questions: ConnectCare.Consent@ahs.ca

Tools

Connect Care provides access to a wide range of clinical scores, scales, calculations and assessment tools. Alberta Health Services (AHS) takes care to ensure that permission is obtained from copyright holders for any tools embedded in the Connect Care clinical information system. With permissions to use the Standardized Mini-Mental State Examination (SMMSE) and the Montreal Cognitive Assessment (MoCA) expired August 31, 2022, AHS has reviewed evidence-based alternatives and obtained permissions for a panel of these in Connect Care.

• Insite: Cognitive Assessment Tools

Prescribers can find cognitive assessment tools via the Flowsheets activity within any opened chart. They are also available in a clinician-friendly format in both a "Scores and Scales" navigator (use chart search for "score" and select "jump to Scores and Scales") and the inpatient chart sidebar (use the sidebar index to navigate to a "Scores" view). Both the navigator and the sidebar have groupings for AHS approved cognitive assessment tools.

The sidebar tools are interactive, in that any score can be selected to update its data then closed with the refreshed data showing in the sidebar. The Sidebar also provides links to the Navigator as well as other clinically useful quantitative tools.

External Guides and Forms

Mental Health Act (compelled treatment)

• AHS: Mental Health Act Forms

  • Includes Form 1 and Form 2 (regarding admissions) and Form 19 (regarding community treatment orders)

  • Forms can be completed online, "printed" to PDF and then attached to the "Chart Review" activity using Media Manager.

Dependency

• GoA: Guide to Capacity Assessment for Guardianship and Trusteeship

• GoA: Office of the Public Guardian and Trustee forms for professionals

• GoA: Form 3 - Capacity Assessment Report (Co-decision-making)

• GoA: Form 4 - Capacity Assessment Report (Guardianship or Trusteeship)

Power of Attorney

• GoA: Enduring power of attorney

Personal Directives

• GoA: Understanding Personal Directives

• GoA: Personal Directive Form

• GoA: Guide to capacity assessment under the Personal Directives Act

• Schedule 2: Declaration of Incapacity to Make Decisions about a Personal Matter

  • Schedule 3: Declaration of Incapacity to Make Decisions about a Personal Matter