The Evaluation of Capacity to Make Admission Decisions: Is it a Fair Process for Idividuals with Communication Barriers?

Abstract

In Ontario the Health Care Consent Act protects the rights of competent patients to understand an alternate discharge destination and to consent to such discharge plans. Social work case managers evaluate the capacity of patients to refuse or accept admission to long-term care facilities by administrating the ‘Capacity to Make Admission Decisions’ questionnaire. The evaluation is a framework to reveal the patient's ability to understand and appreciate a decision. This article will show that the current capacity evaluation is not a fair process for people with communication barriers arising from stroke, progressive neurological diseases or English as a Second Language (ESL). Critical thinking and competency can be preserved but is masked both by the communication barrier and by an evaluation process that is inaccessible to many. This article will also proffer solutions in order to preserve the rights of this particularly vulnerable population.