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Capacity assessment — CCFP MCQ

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ModerateGeriatricsCapacity assessmentCCFP

A 79‑year‑old woman with mild dementia wants to appoint her niece as power of attorney. She can describe her assets, the role of the attorney, and the risk that decisions may be misused. Her son disagrees with her choice. What is the most appropriate next step in management?

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Correct answer: D — Assess and document task‑specific capacity rather than relying on the dementia diagnosis alone

The correct answer is D. Canadian Family Physician (April 2025) emphasises that mental capacity is decision‑specific and must be assessed in relation to each task; dementia itself does not equate to incapacity ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/40228886/?utm_source=openai)). CFPC key feature statements also instruct clinicians not to assume incapacity based on dementia and to assess the patient’s ability to understand and appreciate decisions ([cfpc.ca](https://www.cfpc.ca/uploadedFiles/Education/COE_KF_Final_ENG.pdf?utm_source=openai)). Option B is incorrect because a dementia diagnosis alone is insufficient to declare incapacity. Option A wrongly substitutes next of kin preference over patient autonomy. Option E is inappropriate since family physicians should support legal planning when capacity is present. Option C is incorrect because cognitive screening scores should not solely determine capacity—they must be interpreted in context.

Reference: Canadian Family Physician. When and how to assess decision‑making capacity in your patients. April 2025. https://pubmed.ncbi.nlm.nih.gov/40228886/ (CFP, CA)