Has anyone ever had a capacity assessment done privately?

Discussion in 'I care for a person with dementia' started by Boldredrosie, Aug 14, 2015.

  1. Boldredrosie

    Boldredrosie Registered User

    Mar 13, 2012
    #1 Boldredrosie, Aug 14, 2015
    Last edited: Aug 14, 2015
    I had a colleague who hired a social worker privately to make an assessment of her stepson when the child's mother was planning to remove him from the country and the courts accepted it?
    I wondered if anybody has either privately sourced a psychiatrist or social worker to conduct a capacity assessment? Or is capacity in dementia too fluid and situational for that to be worth anyone's time?
  2. Sue J

    Sue J Registered User

    Dec 9, 2009
    In answer to your question Boldredrosie, no, but its an interesting one. It always disturbs me though that any one individual can make a decision on someone's 'capacity' when they may have never met that person before, and know nothing or very little about them or their circumstances. Be interesting to read your replies.
  3. nitram

    nitram Registered User

    Apr 6, 2011
    North Manchester
    #3 nitram, Aug 14, 2015
    Last edited: Aug 14, 2015
    Capacity has to be assessed for a specific action, The Mental Capacity Act states that 'a person lacks capacity if they are unable to make a specific decision, at a specific time, because of an impairment of, or disturbance in, the functioning of mind or brain.'

    Some, but not all, tests of capacity have to be carried out using a prescribed form eg >>>TEST INVOLVING COP<<<
  4. Saffie

    Saffie Registered User

    Mar 26, 2011
    Near Southampton
    I don't think that happens Sue. The person who signed my husband's form for the Deputyship application was his psychiatric consultant, who was the person who diagnosed his dementia some time before, had overseen his Memory clinic appointments though not actually taken them and wrote all his reports.

    I'm not say that it happens like this every time but I do think the assessor for capacity has to meet the person concerned.

    Boldredrosie, a person only has to show that they understand at any given moment for them to be deemed to have capacity. Would a privately engaged psychiatrist know any more about the relevant person than an NHS one?
  5. Witzend

    Witzend Registered User

    Aug 29, 2007
    SW London
    I have never heard of it, not that that means anything. I would think there might be official objections, i.e. it is open to abuse - someone getting a suitably qualified friend to do it, so they can get P of A and get their hands on the person's money.

    No use pretending such things would never happen - they certainly did in the past.
  6. Blogg

    Blogg Registered User

    Jul 24, 2014
    Capacity can be fluid especially in the earlier stages of dementia. Also someone could have capacity to make some decisions but not others. Is there a specific reason you ask, it can be tricky to get POA once decisions about capacity are queried.
  7. Boldredrosie

    Boldredrosie Registered User

    Mar 13, 2012
    thanks everyone. I did think that perhaps it wasn't something suitable for dementia given the fluctuations in the disease. Somebody suggested it to me as a way forward for the situation we find ourselves but I wasn't sure it was a viable way forward.
  8. ITBookworm

    ITBookworm Registered User

    Oct 26, 2011
    It has to be possible to get a capacity assessment done for someone with dementia since it is possible to set up an LPA that cannot be used until the donor has been deemed to have lost capacity....

    In the case of a financial LPA I would guess the donor would be assessed on their ability to understand financial decisions. In your case I would guess you need to define quite specifically what decision your Mum needs to (or not as the case may be) understand and also understand the consequences.

    So if you think she needs to move into a care home, and she doesn't you need to list what sort of things she needs to be able to do and understand to be safe to leave as she is looking after herself. For example in an emergency (serious fall?) is she able to understand what has happened and call assistance? Would she realise that if she didn't get help soon enough she could (if injured enough) die? Would she wear, and more to the point use, one of the fall sensors? and so on. Is she able to feed herself? If there was some accident to you or one of her other carers or no carer turned up for some time (whatever reason) is she able to call for help?

    You then need to get someone "official" to assess her on her ability to handle the things in this specific area - preferably getting her to demonstrate doing as well as saying!

    Hope that helps :)
  9. Boldredrosie

    Boldredrosie Registered User

    Mar 13, 2012
    #9 Boldredrosie, Aug 14, 2015
    Last edited: Aug 14, 2015
    What an interesting list.
    The emergency call button thing came to late in my mum's dementia for her to get used to wearing it and certainly she couldn't use it when she did.
    She can eat biscuits, banana and yogurts but has difficulty with other food and certainly can't prepare any (although the gin & Ribena mix in a water glass has not yet evaded her capacity)
    No, she can't use the phone and if no carer ever turned up again, she'd be absolutely delighted.
  10. nitram

    nitram Registered User

    Apr 6, 2011
    North Manchester
    "it is possible to set up an LPA that cannot be used until the donor has been deemed to have lost capacity"

    This is implicit in all H&W LPAs.
  11. ITBookworm

    ITBookworm Registered User

    Oct 26, 2011
    Yup, although for whatever reason we never actually had to get an official statement of lack of capacity for FIL to use his (possibly mentioned by consultant in passing in a review but nothing more official) :)

    The finance one though is where the donor might think they still had capacity and the attorney would have to "prove" otherwise if that is what the LPA required. Thankfully when we took over FIL's finances he didn't have enough capacity to do more than complain to us and sulk :(:(:(
  12. jan.s

    jan.s Registered User

    Sep 20, 2011
    My husband had a capacity test completed by a private psychiatrist when we went to the Court of Protection. As expected it confirmed his lack of capacity, and that gave me the right to represent him in the Court.
  13. Dustycat

    Dustycat Registered User

    Jul 14, 2014
    North East
    I've had this mentioned to me as I need to sell my Dad's flat and he can't give me permission. I'm trying in the first instance to see if his consultant will do it. If not may have to go down the route of a private assessment. X
  14. tryingmybest

    tryingmybest Registered User

    May 22, 2015
    My Mother who has never been formerly diagnosed is to have capacity test by someone through the Court of Protection. I'm dreading it as I'm saying my Mother does gave capacity but my sister says not so this is why we are having to go through tho process. Trouble is my mum hates people questioning her who she doesn't know and gets upset so wont do well in this. X
  15. doodle1

    doodle1 Registered User

    May 11, 2012
    My dad was assessed by a private neurologist.if you are near to London the company Re-cognition Health does these tests. I am not sure if you can access them without a Gp referral.The tests they ran were exactly the same as for my mother that were done on the NHS.MMSE,MRI and CT scan.
  16. Spiro

    Spiro Registered User

    Mar 11, 2012
    #16 Spiro, Aug 16, 2015
    Last edited: Aug 17, 2015
    I know of a company which employs elderly care psychiatrists, who can do mental capacity assessments. They are specialists in this area

    If anyone would like details, then please PM me.
  17. chrisdee

    chrisdee Registered User

    Nov 23, 2014
    #17 chrisdee, Aug 16, 2015
    Last edited: Aug 16, 2015
    Just wanted to say that I am totally sympathetic as to why anyone would need an officially acceptable capacity test done. Mental health referred my Mum to a psychiatrist who then assessed capacity, as they knew we were at our wits end and needed to move Mum into care as she was wandering and sinking fast. Several months down the track, and then in care Mum was in hospital and the hospital SW, doing the discharge paperwork, said 'but she says she wants to go home?' and brought up the question of capacity, even though I pointed out POA, and Psy. letter! I think I might have actually screamed down the phone. SW unwilling/scared to make this decision. Sadly Mum passed away a month later. We did manage to get her into a very good NH. My advice is, do what you need to. We understand on here.
  18. looviloo

    looviloo Registered User

    May 3, 2015
    #18 looviloo, Aug 17, 2015
    Last edited: Aug 17, 2015
    So sorry to hear about your mum :-(. Unfortunately, I don't think any of the authorities are willing to make a decision. At least, that's my experience too. I'm in a similar situation to the OP with my dad (he's in a care home and often says wants to go home, despite the obvious difficulties; the house stands empty and needs to be sold).

    So I rang the Office of the Public Guardian - they have a helpline number on the documents - and thought they might help. The advice was that dad's dementia diagnosis goes 'some way' to deeming him incapable of making his own decisions. Some way?! I didn't specifically ask about a capacity test, but neither was it mentioned, and the whole conversation was quite 'woolly'.

    In my case, I've written down all the concerns I would have about dad returning to his house with as much evidence as I can think of as to why these would be a problem. For instance - stairs and stairlift (inability to use one); how he might cope in an emergency; evidence of leaving house unlocked, responding to door-steppers etc; lack of self care being beyond the scope of care visits (in my opinion); general support needs and vulnerability. I've signed and dated it. I'm now thinking of getting social services involved again, since dad's insistence about 'going home' is becoming too much.

    I know our situations are different but I thought it might help to share this, since this thread has been a great help to me!
  19. reedysue

    reedysue Registered User

    Nov 4, 2014
    When we got POA for my mum the solicitor inserted a clause where my mum agreed to her future capacity being decided by her GP or a hospital doctor if or when necessary.
  20. JLSW

    JLSW Registered User

    Jul 23, 2015

    Please remember that mental capacity assessment is time specific and is decision specific; this means that mental capacity can fluctuate which means people can temporarily be deemed to be incapacitated and can also regain capacity. Furthermore a person may be assessed to have capacity concerning one particular decision but not for another decision. This is particularly true of people with mild to moderate dementia who can make some decisions but do not have the capacity to make others.

    Also, if a person is in a care home is requesting to go home the care home will usually apply for a Deprivation of Liberty (DOL) authorisation, i.e. to keep the person somewhere against their will as an action in their best interests. The person will then have a mental capacity assessment carried out by a Best Interests Assessor.

    Finally, a mental capacity assessment can be carried out by a professional on a private basis or through the NHS or Local Authority.


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