Topics of interest · Capacity
Understanding decision-making capacity, in plain terms.
What capacity means, why it is decided one decision at a time, and the questions families and professionals most often ask.
Capacity is the ability to make a particular decision at a particular time. It is not a label a person carries, and it is not all or nothing.
This page explains, in everyday language, what decision-making capacity means and how it is approached in Queensland. It is a companion to our capacity assessment service, which sets out how we can help when there is a genuine question about a specific decision.
What it is
What capacity means
Under Queensland law, a person has capacity for a decision when they can do three things for that decision.
- Understand the nature and effect of the decision, that is, what it involves and what is likely to follow from it
- Decide freely and voluntarily, without being pressured or unduly influenced by someone else
- Communicate the decision in some way, which may be by speaking, writing, or another means
This three-part test comes from the Queensland Guardianship and Administration Act 2000 and the Powers of Attorney Act 1998. A person may need support to do these things, and being given that support is part of a fair assessment.
Two key ideas
Decision-specific, and time-specific
These two ideas explain why a single yes-or-no answer about a person is rarely the right question.
- Capacity is decision-specific. A person may have capacity for some decisions and not others at the same time. Deciding what to wear or what to eat is different from deciding to sell a house or change a will. The more complex the decision, the more is involved in making it
- Capacity is time-specific. It can change, and it can come and go. Illness, delirium, tiredness, pain, medication and stress can all affect it on a given day, and some of these are temporary or treatable
- Capacity is not the same as a wise decision. Adults are entitled to make decisions that others think are unwise or risky. The question is whether the person can make the decision, not whether others agree with it
- A diagnosis does not decide it. Conditions such as dementia, brain injury or intellectual disability do not, by themselves, mean a person lacks capacity for a particular decision
“The law presumes capacity. We assess only where that is genuinely in question.”
The starting point
The law presumes capacity
In Queensland, the law begins by presuming that every adult has capacity to make their own decisions, until it is shown otherwise. That presumption is the starting point, not an obstacle. It means a formal assessment is appropriate where the presumption is genuinely in question for a particular decision, and not as a routine box to tick. It also means a person should be given the support they reasonably need to make and communicate their own decision before anyone concludes they cannot.
Common questions
Questions families and professionals ask
A few of the questions we hear most often, answered plainly.
Mum has dementia. Does that mean she cannot make decisions?
Not on its own. A diagnosis is relevant information, but capacity is assessed against a specific decision at a specific time. Many people with dementia retain capacity for a range of decisions, especially with support and especially earlier in the condition. The right question is always whether she can make this decision now.
Can a person have capacity for one thing but not another?
Yes. Capacity is decision-specific. Someone might be able to decide their day-to-day care but find a complex financial or legal decision beyond them, or the other way around. Each decision is considered on its own terms.
What if my relative is making a decision I think is a mistake?
Adults are allowed to make decisions others see as unwise. A risky or surprising choice is not, by itself, evidence of lost capacity. An assessment looks at whether the person can understand, weigh up and communicate the decision, not at whether the decision is one others would make.
Who actually decides whether someone has capacity?
It depends on the decision. For everyday and medical matters it is often the treating team. For legal documents such as a will or an enduring power of attorney, a solicitor forms a view, sometimes supported by a clinical opinion. Where matters are contested or formal orders are needed, the Queensland Civil and Administrative Tribunal (QCAT) decides. A neuropsychological assessment informs these decisions; it does not replace them.
Is a capacity assessment the same as a memory assessment?
They overlap but are not the same. A memory assessment describes thinking skills in general. A capacity assessment uses that information to address one practical question: can this person make this particular decision? The report is written around the decision in question.
How it helps
How an assessment helps, and who it informs
A neuropsychological capacity assessment brings together a clinical interview, standardised testing of the relevant thinking skills, and, with consent, other information, to form a clear, reasoned opinion about a specific decision. It also looks for temporary or treatable contributors, such as delirium, medication effects or depression, so that a lasting conclusion is not drawn from a passing cause.
The report is written to be useful to the person who holds the decision. Depending on the matter, that may be the person themselves and their family, the treating doctor or team, a solicitor, the Queensland Civil and Administrative Tribunal (QCAT), the Public Guardian or the Public Trustee. We are explicit about what the assessment can and cannot establish, and about who ultimately makes the decision.
For solicitors and treating teams. If you have a matter to discuss, our capacity service page sets out what we need, and you can make a referral or call us. It always helps to tell us which decision is in question.
Have a question about a specific decision?
If there is a genuine question about whether someone can make a particular decision, request an appointment or call 0452 452 262. GPs, solicitors and other professionals can refer through our referrer page. You do not need a referral for a private appointment.
Request an appointmentSources: Guardianship and Administration Act 2000 (Qld) (definition of capacity; presumption of capacity; general principles). Powers of Attorney Act 1998 (Qld). Queensland Government, Queensland Capacity Assessment Guidelines 2020 (capacity is decision-specific and time-specific; always presume capacity; assess the decision-making ability, not the decision). Queensland Civil and Administrative Tribunal (QCAT), Capacity for decision-making. Office of the Public Guardian (Qld), General principles. This page is general information, not legal advice; for advice about a specific situation, consult a solicitor.