Tuesday, 18 February 2020

Determining the Difference between Decisional Capacity and Decisional Competence

If one of your elderly relatives has been diagnosed with dementia, his or her ability to make decisions may be hampered as a result of the condition. This is especially true when it comes to making decisions regarding his or her own care or any decisions relating to financial matters. It is because of this that it is very important to determine decisional capacity and/or decisional competence.

The question is, what is the difference between the two, and who is responsible for assessing your loved one in this regard? We provide the answers below.

What is decisional capacity?

Decisional capacity refers to a person’s ability to make a sound and informed decision. Usually, this is determined with the help of a nurse, doctor, psychologist, or social worker who examines the individual’s cognitive ‘problem’ areas relating to their dementia, and speaks to them in-depth regarding the situation.

Decisional capacity will often need to be re-evaluated from time to time depending on the circumstances in which a decision is required. For example, while the individual may indeed have the capacity to decide who they would prefer as their private live-in companion, they may not have the capacity to decide how to invest their retirement funds.

In most cases, it is essential to ensure that the individual properly understands the situation around which the decision revolves. It can be helpful to ask him or her to explain the unique circumstances in his or her own words. It is also always wise to speak to the elderly relative about all of the options available to them and to request that they list the pros and cons of each. Once your relative has made their decision, ask them to explain to you exactly why they have opted to go that route. Even without a clinician present, it should be fairly obvious whether the decisional capacity is there or not.

What is decisional competence?

Decisional competence, on the other hand, is a legal term and is evaluated by a judge in special circumstances when an important decision is to be made regarding an individual’s affairs. A judgement regarding decisional competence may only be necessary if someone close to the individual has raised concern to the court that the individual’s decision-making capacity is impaired.  

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