What specific criteria should I use to assess a patient's mental capacity in a primary care setting?

To assess a patient's mental capacity in a primary care setting, use the following specific criteria based on the Mental Capacity Act 2005 and UK guidelines:

• Assume capacity initially: A person must be assumed to have capacity unless it is established otherwise on the balance of probabilities ¹.
• Decision-specific assessment: Capacity must be assessed in relation to the particular decision at the time it needs to be made ¹.
• Identify impairment or disturbance: Confirm that any inability to make the decision is due to an impairment or disturbance in the functioning of the mind or brain ¹.
• Assess understanding: Determine if the person can understand the information relevant to the decision, including the salient factors and options available ¹.
• Assess retention: Check if the person can retain that information long enough to make the decision ¹.
• Assess weighing up: Evaluate whether the person can use or weigh that information as part of the decision-making process ¹.
• Assess communication: Confirm the person can communicate their decision by any means, including verbal, non-verbal, or other forms ¹.
• Support and reasonable adjustments: Ensure all practicable steps have been taken to support the person’s decision-making, such as using communication aids, involving trusted individuals, or adjusting timing and environment ¹.
• Do not judge based on perceived wisdom: Do not assume lack of capacity because the decision seems unwise or risky ¹.
• Use a collaborative, person-centred approach: Conduct the assessment respectfully, non-judgmentally, and in a way that preserves dignity, involving others as appropriate ¹.

These criteria should be applied proportionately to the complexity and significance of the decision, and the assessment should be documented clearly ¹.