Review of capacity assessments and recommendations for examining capacity.

AIM: To audit the capacity assessments performed since December 2007 by Community Geriatric Services (CGS), Middlemore Hospital, and to develop a resource kit for training health professionals.
METHOD: 1343 clinical letters were reviewed. Demographic data, reason for assessment and outcome of assessment were recorded. Data was analysed to reveal trends.
RESULTS: There were 87 capacity assessments on 82 unique patients. The numbers of referrals for capacity assessments have increased since December 2007. 63% of patients were female, and the majority were European (75.6%). The mean age was 80.3 years. 66.7% of patients were referred by their general practitioner (GP). Dementia was the most common diagnosis. Fifty patients had more than one reason for referral. Thirty-seven were assessed for appointing an enduring power of attorney (EPOA), 44 for financial welfare, 73 for personal welfare, and two for testamentary capacity. Forty-five lacked capacity for all aspects assessed. Twenty-three did not have an EPOA and appointment of a guardian was recommended for 16 patients.
CONCLUSION: The CGS is performing more capacity assessments over time. The majority of the patients are elderly and have dementia. There is a need to train specialist nurses and general practitioners to perform capacity assessments. A resource kit has been developed for this purpose.