Decision Making Capacity Evaluations

The capacity to make one’s own decisions is fundamental to the ethical principle of respect for autonomy and is a key component of informed consent to medical treatment. Determining whether an individual has adequate capacity to make specific decisions should be addressed on a question-by question basis.

The main determinant of capacity is cognition (i.e., memory and thinking).

There is a wide range of medical and neurologic conditions and treatments that can affect cognition and thus affect someone’s ability to make independent decisions.

Given that the concept of “capacity” is complex and multifaceted, Silicon Valley Assessment aims to strike a balance between respecting our client’s independence and acting in our client’s best interests. As such, each evaluation is uniquely tailored toward your needs and specific questions you are hoping to answer.


To describe a person’s ability to make an informed and specific decision.

A skillful capacity assessment helps to determine the severity of our client’s cognitive difficulties and how they may impact his/her ability to:

  • Decide whether or not to receive a specific treatment
  • Decide how and who should assist with financial decisions
  • Decide whether or not to appoint someone as his/her’s Power of Attorney

We can help families to effectively communicate with their loved ones who may or may not be able to make such decisions any longer.


A clinical interview with the client and a significant other (family member)

A battery of measures that address and describe cognitive abilities that are thought to be crucial in someone’s capacity to

  • Understand presented information
  • Express a choice within one’s value system
  • Appreciate the nature of risks and benefits associated with the question asked
  • Reason logically through the choices

Standardized measures assessing the following domains:

  • Overall functional status
  • Overall cognitive status
  • Language comprehension
  • Communication
  • Judgment
  • Reasoning
  • Memory

Feedback includes

  • A comprehensive report with detailed explanation of the results and recommendations
  • Feedback with the client and family
  • Assistance with completing the necessary applications and paperwork needed to file for Power of Attorney/Health Care Advance Directives