Where can I get a decisional capacity evaluation in Northern Virginia?
DocTalker Family Medicine performs decisional capacity evaluations for patients and families across Northern Virginia. A capacity evaluation is a physician’s assessment of whether a person is able to understand and make a specific decision, such as a medical or care decision, at a particular point in time. Our physicians can perform the evaluation in our Vienna office or in the person’s home or care facility, and provide a clear written assessment of the findings.
Many families seek a capacity evaluation when a loved one may no longer be able to make their own medical decisions. Under Virginia law, before the agent named in a medical power of attorney, or a next of kin, can step in to make health care decisions for someone, a physician must first certify in writing that the person is incapable of making an informed decision. For most medical decisions this involves two qualified clinicians: your loved one’s PCP and us here at Doctalker as the second. We are readily available to assist with capacity evaluations as we understand timely evaluation is of upmost importance for loved ones to assist with both finances and healthcare decision making.
Capacity is not the same as legal competency
It helps to understand the difference between two terms that are often confused. Capacity is a clinical judgment made by a physician about a person’s ability to understand and make a particular decision, and it can change over time or differ from one decision to another. Competency is a broader legal status that only a court can decide. DocTalker provides the clinical capacity evaluation and written findings; how that assessment is used in any legal matter is determined by the court and your attorney.
What a DocTalker capacity evaluation includes
A capacity evaluation is an unhurried, in-person assessment focused on a specific decision. A typical evaluation includes:
- A review of the person’s relevant medical history and current medications A focused assessment of memory, attention, and reasoning
- An evaluation of whether the person can understand the decision, appreciate how it applies to them, reason through the options, and clearly express a choice
- Consideration of any reversible factors that may be affecting thinking, such as infection, medication effects, or dehydration. Blood work can also be drawn if appropriate.
- A detailed letter and evaluation to share with attorneys and other providers as needed.
We take the time to do this carefully and respectfully, recognizing how significant these decisions are for the person and their family.
A capacity evaluation is a physician’s assessment of whether a person is able to understand and make a specific decision, such as consenting to a medical treatment, managing finances, or deciding where to live. It looks at whether the person can understand the relevant information, appreciate how it applies to them, reason through the choices, and express a decision.
Capacity is a clinical assessment made by a physician and is specific to a particular decision and moment in time. Competency is a legal status that only a court can determine. A physician provides the capacity assessment; a judge decides competency.
For health care decisions, generally yes. Virginia law requires that a person be certified in writing as incapable of making an informed decision by the attending physician and a second qualified clinician, either another physician or a licensed clinical psychologist, each after a personal examination, before a health care agent named in a medical power of attorney or a next of kin can make medical decisions on their behalf. A capacity evaluation provides that assessment and the written documentation. This requirement applies to health care decisions; financial matters and guardianship follow different legal processes.
Capacity evaluations are often requested by families, caregivers, facilities, or attorneys when there are concerns about whether an older adult or a person with a medical or cognitive condition can safely make a particular decision.
Yes. DocTalker physicians can perform capacity evaluations in your home or at an assisted living or care facility across Northern Virginia, as well as in our Vienna office.
A capacity evaluation is billed as a separate service. The fee starts at $800-$1200 and includes the in-person assessment and the written findings as well as a letter to provide those of need.
On average, a written assessment can be provided in 3 business days or sooner.
No. Capacity evaluations are available to DocTalker members and, to those who are not members.
Call us at (703) 938-4600 EXT 2 to tell us a little about the situation and the decision involved, and we will arrange an appointment.