Mental Capacity: Communication

When we last spoke, I shared a brief story of how thoughtful communication can be the difference between assessing a person as having capacity to make a decision or not. Today, I’d like to share two different aspects of communication in relation to assessing mental capacity.

First, in order to assess a person as having capacity to make a decision they have to be able to communicate their decision.  Now that of course doesn’t necessarily mean verbal communication or even speaking in English. If a person is attempting to communicate with us, it’s up to us as decision makers to do whatever we can to understand what they are saying. Whether that’s using an interpreter, sign language, pictures or effectively reading their body language. I’ve come across very few people who aren’t able to communicate in one way or another. They were largely in the context of an acute hospital and the decision could wait until they were not acutely unwell. On one occasion, I had a PECS crash-course. PECS is a method of non-verbal communication that involves people exchanging pictures and symbols. And was the only method of communication that this person had.

The other aspect of communication is our communication. How effective is our communication? Do we only use verbal communication or thoughtfully consider the best methods of communication for the person? An assessment of a person’s mental capacity to make a particular decision isn’t a robust assessment if we’re not able to share the relevant inform with them in a way they’re likely to understand.  I met a lady once who had forgotten all of the English she had learnt over the previous 20 years of living here and could only speak in Polish. My assessment would have been very ineffective if her family hadn’t recognised this. They were also able to translate for us as well.