精神行為能力評估環境建議

Try to minimise anxiety or stress by making the person feel at ease.

If the cause of the incapacity can be treated, the doctor should, in so far as possible, treat it before the assessment of capacity is made.

If the person's capacity is likely to improve, wait until it has improved. Obviously, if the assessment is urgent it may not be possible to wait.

Be aware of any medication which could affect capacity (e.g. medication which causes drowsiness). Consider delaying the assessment until any negative effects of medication have subsided.

If there are communication or language problems, consider enlisting the services of a speech therapist or a translator, or consult family members on the best methods of communication.

Be aware of any cultural, ethnic or religious factors which may have a bearing on the person's way of thinking, behaviour or communication.

Choose the best time of day for the examination. Some people are better in the morning; others are more alert in the afternoon or early evening.

Be thorough, but complete the assessment within a reasonable time to avoid tiring or confusing the client.

Avoid obtrusive time-checking. It should be possible, without too much discernible eye movement, to keep a check on the time.

If more than one test of capacity has to be applied, try to do each assessment on a different day, if possible.

Choose the best location. Usually, someone will feel more comfortable in their own home than in, say, a doctor's surgery or a lawyer's office.

Try to ensure that there are no obstructions between you and the client which could hinder the development of a relationship of equals - for example, consider the height and positioning of the chairs.

So far as it is within your control, make sure that the temperature in the room is comfortable and that the lighting is soft and indirect, but sufficiently bright for easy eye contact and interpretation of expression and to allow you to study any relevant documentation.

Consider whether or not a third party should be present. In some cases the presence of a relative, friend or other person (such as an advocate or attorney) could reduce anxiety. In others, their presence might actually increase anxiety. In some cases a third party might be a useful interpreter. In others, they could be intrusive. Be aware also of the potential that the third party might have their own interests (pecuniary or otherwise) in the outcome of the assessment.

Try to eliminate any background noise or distractions, such as the television or radio, or people talking.

If possible, make sure that other people cannot overhear you and that others will not interrupt you, from either within or outside the room - for example, by telephone.

Be sensitive towards disabilities, such as impaired hearing or eyesight, which could mislead you into assuming that a person lacks capacity.

Speak at a volume and speed that can be easily understood. Try to use short sentences with familiar words. If necessary, accompany your speech with slightly exaggerated gestures or facial expressions and other means of nonverbal communication.

If necessary, provide verbal or visual aids to stimulate and improve the person's memory.

If carrying out more than one test of cognitive functioning, allow a reasonable time for general relaxed conversation between each test so as to avoid any sense of disappointment at failing a particular test.

If possible, try to avoid subjecting the client to an increasingly demoralising sequence of “I don't know' answers.

Take one decision at a time - be careful to avoid making the client tired or confused.

Don't rush - allow the client time to think things over or ask for clarification where that is possible and appropriate.

Some organisations (e.g. BILD, Mencap and Sense) have produced specialised material to support decision-making, and decision-makers should consider whether it is appropriate to use it.

It may be appropriate to provide access to relevant supportive technology.