Capacity Assessment

Independent assessments of an adult’s ability to make their own decisions, for lawyers, families, and referring professionals.

Conducted by Dr. Reagan Gale, a designated capacity assessor in Ontario who is also licensed in Alberta, Nunavut, the Northwest Territories, and the Yukon.

What is a capacity assessment?

When a question arises about whether an adult is capable of making a particular decision, about their property, their personal care, a will, or a power of attorney, a formal capacity assessment provides an independent, documented answer.

Capacity assessments at Dr. Day & Associates are conducted by Dr. Reagan Gale, who has practised clinical neuropsychology independently since 2012 and is a designated capacity assessor in Ontario. As a practice specializing in neuropsychology, we bring particular depth in what these questions turn on: how cognition, memory, reasoning, insight, and judgement shape a person’s ability to decide.

A capacity assessment is a structured, specialized evaluation of a person’s ability to understand the information relevant to a decision, and to appreciate the reasonably foreseeable consequences of making, or not making, that decision.

Types of capacity we assess

Property, the ability to manage one’s finances and assets
Personal care, the ability to make decisions about housing, safety, nutrition, hygiene, and related personal matters
Testamentary capacity, the capacity to make a valid will
Capacity to instruct counsel, including the ability to give instructions to a lawyer in litigation
Capacity to grant or revoke a power of attorney

A note on health-care decisions. An assessment of a person’s capacity to consent to a specific treatment must be carried out by the health provider proposing that care. Those assessments therefore fall outside the scope of the services we offer. Note that capacity for personal care and capacity to consent to health care are different questions, despite sounding similar.

Making a referral

In almost all cases, we require an initial referral from the individual’s lawyer. Your lawyer is best placed to advise our office what type of assessment is required, why it is being sought, and whether the person to be assessed is able and willing to speak with us. The lawyer is responsible for payment of our fees.

There is one exception. For residents of Ontario seeking an assessment of capacity to manage property in order to initiate statutory guardianship through the Public Guardian and Trustee, a referral from a lawyer is not required. In those cases we complete a screening interview before accepting the referral, and the individual or agency making the referral is responsible for payment of our fees.

Consultation. If you would like to discuss your situation and you have not yet consulted your lawyer, you may wish to schedule an appointment with us for a consultation. For this type of consultation, our fee is $325/hour + HST. Arrangements for payment must be finalized in advance.

There is no single test of capacity. It is always assessed in relation to a specific decision, and a person may be entirely capable in one area while requiring support in another.

What the assessment involves

Assessment appointments typically take one to two hours. Depending on the type of assessment being requested, the process may also include:

A detailed clinical interview (usually one to three hours)
A detailed document review (approximately 100 pages per hour)
Standardized tests and procedures measuring the relevant domains of cognitive ability, decision-making, and general judgement, insight, and risk-evaluation ability (two to five hours). These may cover intelligence, cognitive screens, functional adaptation, attention (processing speed, sustained and divided attention, complex attention), memory and learning (auditory vs. visual, incidental memory, complex), executive functions (planning, organization, problem solving), and language (receptive and expressive).

The assessment results in a formal written report. In most situations, reports are prepared within two to four weeks of the assessment appointment.

Where assessments take place

Assessments can be scheduled at our Kingston or Trenton clinic, or at another location convenient to the individual, including their home. Dr. Gale also meets with clients in hospital and in long-term care. In some situations, virtual appointments by videoconference may be possible.

Dr. Gale is licensed to conduct assessments in Alberta, Ontario, Nunavut, the Northwest Territories, and the Yukon, and is pleased to travel to work with clients in northern, rural, and remote communities.

She has post-graduate training in incapability assessment from the Institute of Gerontology at Wayne State University, served on the Yukon Capability and Consent Board from 2017 to 2021, was appointed Public Guardian and Trustee for Yukon in 2021, and is a Past-President of the College of Alberta Psychologists.

Fees

Capacity assessments are not publicly funded. The cost of an assessment depends on the complexity of the situation and the number of hours required to complete it. Assessments of capacity to manage property generally cost between $1,500 and $2,000, plus HST for residents of Ontario, or GST.

In Ontario, financial assistance may be available through the Capacity Assessment Office. See Ontario’s mental capacity information page for details.