Mental capacity and decision-making

Mental capacity is the legal term used to describe the ability to understand, weigh up, make and communicate a decision. It is a key right in healthcare, being central to the consent process as well as the safeguarding of personal choice and autonomy. Assessing mental capacity in the context of neurological impairment is often complex as speech, language and cognitive communication needs of people with acquired brain injury frequently impact on one or several stages in decision-making. SLTs have a key role in offering optimal support and assessing capacity whilst also allowing truly free decision-making. This chapter includes the key research to define an SLTs role in the assessment of mental capacity, facilitating an individual to express their views and advocating for them. There are case studies showcasing strategies to use. Practical clinical resources include a capacity assessment record form and a best interests assessment record form. In addition, there are links to further professional guidance and useful resources from other sources and an example of yes/no reversible questions to use when assessing capacity in relation to eating and drinking available online.