Capacity testing can be more difficult than it sounds. Capacity should be presumed, specific and facilitated. This means we must help people to understand and to be able to express their views.

Presumed:
We must treat all patients as having capacity to make their own decisions unless there is evidence that they do not have capacity. A diagnosis of dementia does not mean the patient does not have capacity.

Specific:
Capacity is specific to a decision and it is important not to treat a patient who doesn't have capacity to make a big decision such as whether it is safe for them to live independently in their own home, as not having capacity to make smaller decisions such as whether to have a wash in the morning.

Facilitated:
Health care professionals must do everything they can to help communication with the patient when assessing capacity. This includes where appropriate using hearing-aids, pictures or demonstrations, or an interpreter if the patient does not understand English.