Assessment of decision-making capacity: Exploration of common practices among neuropsychologists

Demands on neuropsychologists to assess decision-making capacity have increased over the years. Debate exists about appropriate methodology, and there is a prevailing attitude that neuropsychologists would benefit from a more consistent approach across the profession. This paper presents findings from a sample of Australian neuropsychologists (n = 52) who responded to an email questionnaire assessing how neuropsychologists approach assessments of decision-making capacity and their satisfaction with current practices. Responses indicated that most neuropsychologists use a combination of formal assessment and informal interview. Likely completion time for a decision-making capacity assessment was 6 – 8 hr for 39% of respondents, and >8 hr for 35%. Neuropsychologists felt valued for their input in this area but most felt poorly prepared by their training. More than half of the respondents rated assessing decision-making capacity as time-consuming, stressful, and difficult. Findings relating to the strategies of assessment are discussed.