Section 3 Capacity assessment principles

 

Section 3 has three parts. Select a link from the list below for more information about each topic

There are six principles to be applied when assessing a person’s capacity. They aim to support and protect people, and help them to make the most of their decision-making ability.

Capacity assessment principles

  1. Always presume a person has capacity
  2. Capacity is decision specific
  3. Don’t assume a person lacks capacity based on appearances
  4. Assess the person’s decision-making ability – not the decision they make
  5. Respect a person’s privacy
  6. Substitute decision-making is a last resort

1. Always presume a person has capacity

The most basic principle is to presume a person has the capacity to make all decisions for themself. Every adult is free to make their own decisions if they have the capacity. As a family member, friend, carer, or other individual involved with a person, you should always make this presumption unless it is established that they don’t have the capacity to make a particular decision

Culture, language, ethnicity and religious impacts

When applying this principle, consider how a person’s culture, language, ethnicity or religion impacts on their freedom to make decisions. For example, in some communities and in some families, a person may regularly allow or prefer the head of a household, a parent or an elder of the community to make all the important decisions. This means individuals with capacity to make their own decisions may freely allow others to make important decisions on their behalf.

Sometimes the decision-making process is collective and involves the whole community in meetings and discussions about the decision, such as in some Indigenous communities. Also, some religious beliefs may impact on the decision made, or how it is made. For example, some Jehovah’s Witnesses and Christian Scientists hold particular beliefs that might affect their decisions about various medical treatments.

Presumption versus protection

Even with a presumption of capacity, it is still important to think about the balance between a person’s right to make a decision and the extent to which that person’s health or safety might be in danger if they can’t make a decision. This can be a very difficult balancing exercise.

If you are faced with this situation be mindful not to act in an overly protective way when assessing whether a person has capacity. Protecting a person from making what you think is an unwise decision may seem helpful, but it is often best not to intervene. It is important to understand that if a person isn’t allowed to confront a difficult decision or its consequences, their right to be in control of their life is denied. Each individual has the right to take their own chances and make their own mistakes. Remember that making an unwise decision, or one that you don’t agree with, does not mean that a person lacks capacity.      

Challenging the presumption

If you are claiming that a person doesn’t have capacity you need to give good reasons. Use facts to show that it is more likely than not that the person lacked the ability to make the decision at the time.

Providing facts and demonstrating a person’s inability to make a decision can be as simple as doing the following:

  • documenting the assessment process
  • providing a summary of the questions you asked the person and their answers, and
  • giving an explanation as to the reasons why you made your decision.

You may only need to satisfy yourself of the facts. For example, you may be an attorney (under a power of attorney) or an enduring guardian making a decision about whether to use your powers. Or, if you are a professional providing a service to a person, you may need to provide reasons to others, such as family members or friends. For example, you may be a solicitor refusing to draw up a power of attorney for a person whom you have assessed as lacking the capacity to make the power of attorney.

Providing reasons for your decision about a person’s capacity may be done in a more formal way if the person, or someone else, challenges your decision. Keeping detailed notes of an assessment and writing down why you made the decision is therefore essential.

Here are some examples of when good notes will be useful.

  • A doctor may decide that their patient has the capacity to consent to a risky operation. If the patient suffers harmful side effects as a result of the operation, the doctor may need to explain the capacity assessment decision to the family or even the Health Care Complaints Commission.
  • A lawyer may be required to show that their capacity assessment of a client was correct if the validity of their client’s will is being disputed in court.
  • A bank teller may need to provide details about deciding that a customer had the capacity to transfer a large sum of money from their account to the account of another. This is particularly the case when the customer normally only makes regular small transactions. A family member of the customer may try to argue that the bank is responsible for return of the funds because the person shouldn’t have been assessed as having the capacity to make such an important financial decision. The matter might be before a court or being mediated by an organisation, such as the Banking and Financial Services Ombudsman.
  • An assessment of capacity may be put before the Supreme Court, Guardianship Tribunal or Mental Health Review Tribunal for consideration if there is an issue of capacity being determined by them.

Case Study

Assuming capacity

‘I don’t like arguing with my sister Eugina, but she thinks that because my brother has been told that he has Alzheimer’s, it means he can’t make any decisions for himself.

I tried to explain to Eugina that you have to have reasons, evidence if you like, to show that someone can’t make a decision about something for themselves. I know that she is just being protective, but she doesn’t have to worry. When Eugina actually sees him I think she will understand. (She doesn’t live near us). He might have been told that he has Alzheimer’s, but the idea is not to strip him of his right to live his life like he wants. Eugina and I should monitor the things he can and can’t do before taking over any decisions.'

Nicias, brother


2. Capacity is decision specific

You need to assess, or seek an assessment of, the person’s capacity for each decision, whenever there is doubt about capacity. This is because a person’s capacity can vary in different circumstances, at different times, and about different types of decisions. If a person can make some but not all decisions, then they have a right to make as many decisions as they can.      

Remember, even if a person couldn’t make a certain decision in the past, they might be able to make:

  • the same type of decision now or in the future
  • other types of decisions now or in the future.

So every time a decision needs to be made, you should ask the question:

 ‘Does the person have the capacity to make this decision now?’

If the person is unable to make a decision about something now, think about whether the decision may be delayed to a later time when the person may be able to make the decision for themself. Delaying the decision will give them the greatest control over their own life.

Case Study

Decision specific capacity

‘I am my husband, Stephan’s, carer. When Stephan can’t make decisions for himself about his daily activities and life, I make them for him. Every day is different really. Sometimes Stephan has clarity and can understand things. That’s when he makes his own decisions. At other times, he doesn’t comprehend things enough to make his own mind up, and then I make decisions for him. I never really know what to expect. I always start by thinking, "Stephan has the right to make any decision he can." I assume that he is able to make his mind up unless it’s obvious to me (after I discuss things with him) that he doesn’t understand.

If things are urgent and important and I think that Stephan is having an ‘unclear’ day, I will jump in and make the decisions for him then and there. Otherwise I will wait until he can make the decision himself.’

Ada, wife and carer


3. Don't assume a person lacks capacity based on appearances

It is wrong to assume a person lacks capacity because of their age, appearance, disability, behaviour, language skills or any other condition or characteristic.

In fact, it may be discrimination under the law if you make unsupported assumptions about a person’s lack of capacity because of the way they look or behave.

Incorrect assumptions can often be made about a person’s lack of capacity based on any of the following:

  • the way a person looks: physical characteristics such as scars, skin colour,features linked to Down’s Syndrome or muscle spasms caused by Cerebral Palsy, or other characteristics linked to cultural or religious practice
  • the way a person presents: attention to hygiene, tattoos,body piercings, a dishevelled appearance, or irregular clothing
  • the way a person communicates: difficulty expressing themself, lack of English language skills, slurring of speech, using an Alternative and Augmentative Communication (AAC) system        
  • a person’s impairment: physical disabilities, learning difficulties and disabilities such as Aspergers or Attention Deficit Hyperactive Disorder (ADHD), illnesses related to age or neurological function such as Multiple Sclerosis,Parkinson’s Disease or Motor Neurone Disease, and temporary conditions such as being drunk or unconscious
  • the way a person acts or behaves: being an extrovert (shouting or gesticulating), behaving in a withdrawn way (talking to oneself or avoiding eye contact), and actions that are connected to a particular cultural or religious belief (such as allowing or preferring another person, or the community group, to make a decision on your behalf).  

Case Study

Capacity and appearance

‘I am a person with Cerebral Palsy. I find it difficult to communicate. I have problems moving my lips, tongue, jaw and face muscles. When I speak it is hard to understand me, but if you listen carefully you can tell what I’m saying.

I remember going into the bank one day wanting to withdraw money from my account. I don’t know whether it was the communication difficulty or the way I looked (sometimes my muscles make jerky movements), but the bank teller obviously thought I couldn’t understand anything. He was speaking to me as though I were a two-year-old, and shouting as though I couldn’t hear him. He didn’t process my transaction, telling me “I had better get some help with it”.

Well, I reckon he needed the help! I can’t believe he didn’t sit down with me and make the time to try to understand me. He just took one look, and because of my disability he thought I didn’t understand what I was doing. I ended up getting a friend to come with me and explain it to him. How humiliating!  For him, me, and the bank. People shouldn’t make assumptions based on looks.’

Melissa, customer    


4. Assess the person’s decision-making ability – not the decision they make

You can’t decide that a person lacks capacity just because they make a decision you think is unwise, reckless, or wrong.

Everyone has their own values, morals, beliefs, attitudes,likes and dislikes. You might think a decision is bad yet someone else will think it is good.

The majority of people take chances or make ‘bad’ decisions once in a while. The right to make a decision includes the right to take risks and to make decisions with which others disagree. This is known as dignity of risk.

However, you may question a person’s capacity to make a decision if they make a decision that either:

  • puts them at significant risk of harm or mistreatment
  • is very different from their usual decisions.

When questioning a person’s capacity, you may also consider:

  • the person’s past decisions and choices
  • whether they are easily influenced or pressured by others
  • whether they have developed a medical condition which might affect their decision-making
  • providing more information to assist them to understand what’s involved in the decision,and its consequences.

Case Study

Assess decision-making ability

‘My mum has Bipolar Disorder. Sometimes when she has episodes of mania she does things I think are reckless, like going out and paying lots of money for a puppy that she won’t want or be able to look after later. She’s done this a lot. I try to get her to see the history and what will happen but she doesn’t listen at that point. It annoys me but it’s not life threatening or harmful to anyone else, so I go along with it. I usually find a home for the dog later.

On the other hand, sometimes Mum gets so depressed that she refuses to eat or leave her bed. She refuses to see a doctor. I don’t think her decision-making is good then, and I make decisions on her behalf to get help.’

Jan, daughter


5. Respect a person’s privacy

Respect a person’s right to privacy when you are assessing their capacity. When you are assessing a person’s capacity you are dealing with a person’s personal information.

‘Personal information’ generally means any information or any opinion about a person that can identify that person.

Various privacy laws and principles aim to protect the privacy of a person being assessed. These principles also balance a person’s privacy interests against their personal interests such as health or safety.

The most common privacy principles are about:

  • collecting information about a person
  • using information about a person
  • disclosing (providing) a person’s information to someone else

It is important to remember that ‘health information’ is a type of personal information. It often has its own health privacy principles that cover the ideas outlined below.

Collecting information

Always ask the person being assessed for the information you need for a capacity assessment. Explain why you need the information and what you will be doing with it.

If you need to get information about the person from others for the purpose of assessment, explain this to the person you are assessing. Ask the person if it is okay to speak to the others to get this information. Don’t generalise about whom you will talk to. Name, or at least clearly identify, the other people – for example, ‘your sister Hannah’, ‘your doctor, Dr Gordon’, ‘the woman from Home Care who comes to help you get dressed on Tuesdays’.

Whether you are talking to the person or someone else, ask only for information that is relevant to the assessment.

It is also a good idea to tell the person you are assessing that they can see the information you are collecting about them if they want to.

Using information

When you have collected personal information to help you assess a person’s capacity, you can only use it for that purpose. If you need to use it for another purpose, you need to ask the person.

There are some exceptions to this rule. For example, you can use the information collected to deal with a serious danger to a person’s health or safety. This exception only applies when the danger is something that is about to happen. It doesn’t apply if the possible danger is in the distant future.

Disclosing information

If you are going to give the personal information you have collected to anyone, you have to get permission. When asking for permission, tell the person exactly to whom you are going to give their information, and why. Again, there are exceptions. For example, you can give the personal information to others without permission if they need it to deal with a serious and immediate danger to a person’s health or safety. It doesn’t apply if the possible danger is in the distant future.

Case Study

Privacy

‘A client came in asking me to draft a will for him. After I went through the usual legal questions I had doubts as to whether the person had the capacity to make a will. It was really hard to decide, so I thought I needed to ask their GP for some information.

I explained this to the client, telling him that it was not unusual to want further information in these circumstances, and I went through the benefits for him to have things done properly. I asked the client to sign a form giving me permission to seek personal health information from his GP.

I drafted up a letter to the GP asking for some specific opinions, and wrote a paragraph confirming that the client had given me permission to ask the GP about his personal information. I attached a copy of the client’s permission form.

Although it is sometimes hard to tell a client that I need another opinion about their capacity, most clients can see the logic after I outline the advantages. Asking the client to sign a privacy form giving me permission to access the GP’s information also means the GP’s disclosure is ethical.’

Nyla, lawyer


  More information - Privacy links

6. Substitute decision-making is a last resort

Consider assisted decision-making

A person may be able to make a particular decision at a certain time because they have support during the decision-making process. This is called assisted decision-making.

They might not have the capacity to make the same decision at another time without that support.

Before deciding that a person does not have the capacity to make a decision, you should ensure that everything possible has been done to support them to make their decision.  Remember, substitute decision-making should be a last resort and used only when all efforts to assist a person to make a decision for themself have been unsuccessful.

The type of assistance you provide, or get, for a person to support them to make a decision for themself depends on matters such as personal circumstances, the type of decision, and the time available to make the decision.

When seeking support for a person to make a decision, you can try the following:

  • use the most appropriate form of communication for the individual, such as non-verbal communication, visual aids (photographs, symbols, drawings), or other alternative formats. You may need to take advice on an Alternative and Augmentative Communication (AAC) system, or obtain a communication assessment from a speech therapist or other professional.       
  • provide information in a more accessible form, such as a neutral interpreter or advocate.        
  • find a particular location or better time of the day so the person might feel more at ease to make decisions
  • suggest to, or assist, the person to get treatment for a medical condition that may be affecting their capacity
  • support the person to resolve, or to get help in resolving, underlying personal or social issues which are causing them stress
  • help the person find someone to support them to make choices or express a view, such as an advocate or behavioural support practitioner
  • help the person find, or get access to, a structured program to improve their capacity to make particular decisions, such as learning a new skill or improving their communication
  • give the person relevant information about the decision and its consequences.
    There is more information about supporting a person to make their own decisions in Section 6 on page 149.

Remember, if you are supporting a person to make a decision for themself you must not act in a way that might influence their decision. It is not your role to persuade a person to make what you think is the ‘correct’ decision, or to pressure them into making the decision that you would make. It is best not to talk about your own opinion. Simply assist the person to work through the decision-making process by providing information and support in a way they feel comfortable.

Case Study

Supporting someone to make their own decision

‘I was working in the emergency department of the hospital one night when a man, Mark, was bought in by the ambos. Mark had been in a car accident and was conscious, but in shock. He didn’t seem to be able to speak and seemed really distressed. He was making noises and wild gestures.

I thought Mark lacked the capacity to make decisions about the treatment of his injuries because he wasn’t talking or listening to what I was trying to explain to him. To me, he didn’t seem to comprehend. I put this behaviour down to the severe shock he was suffering,and decided to give him urgent treatment without consent.

Luckily, before I started any treatment a nurse said that she thought Mark was using sign language. She tried signing to him and he immediately relaxed and signed back. It turns out he did have complete capacity! What I thought was non-communication and wild gesturing due to shock was actually Mark’s desperate attempt to show me he was deaf. I just wasn’t giving him information in the right way. In fact, he could answer my written questions, and I was able to get Mark to make all his own medical decisions.’

Minh, registrar


Substitute decision-making

If all efforts fail to support a person through the decision-making process, you can then determine that the person doesn’t have capacity to make the decision. At that stage, someone called a ‘substitute decision-maker’ might need to make the decision for them. This is a last resort.

Substitute decision-making can happen informally where the person has family, friends or carers who can make decisions for them when the decisions are not major. It can also happen formally where there is a formal legal arrangement in place for someone to make substitute decisions by using an advance care directive, an enduring guardianship, or a power of attorney. Also, the Supreme Court or Guardianship Tribunal can consider appointing someone as a substitute decision-maker, such as a financial manager or a guardian, when:

  • there is no one available to make substitute decisions informally
  • the person hasn’t put legal arrangements in place to appoint someone to make decisions for them when they lack capacity
  • there is a disagreement or problem preventing decisions from being made.

Where the person is a patient in a mental health facility, or where the matter has been referred to the Mental Health Review Tribunal (MHRT) by a court, the MHRT can appoint a financial manager.

If the Supreme Court or a tribunal finds that a person does not have the capacity to make particular decisions and appoints a substitute decision-maker for some decisions, this does not automatically mean that the person does not have the capacity to make other types of decisions.

Remember, substitute decision-making should be a last resort and used only when all efforts to assist a person to make a decision for themself have been unsuccessful.

Case Study

Formal substitute decision-maker

‘My old boyfriend has a severe head injury from a motorcycle accident. He had been really clever, and still retained a lot of his ability to think and communicate. However, he now has little insight into some decisions, especially those about money.

Fortunately, for years after the accident I supported him to make most decisions about his finances on his own, and he was happy for the support. It was just an informal arrangement. All I really did was go through his expenses with him each month and talk him through the advantages and disadvantages of spending his money on certain things. I also encouraged him to get professional advice about long-term investments or spending.

Then we split up. He started to try to look after his own money, but seemed unable to do it now that my support wasn’t there. I think his friend decided to apply to the Guardianship Tribunal for a financial management order because he was worried that the insurance money (which he was supposed to live off) was being spent quickly on unnecessary large items. The Tribunal made an order for a substitute decision-maker, called a financial manager, to make his financial decisions.’

Tania, ex-girlfriend


  More Information - substitute decision making links

 

When should capacity be assessed

Triggers

It is not always obvious when a person can’t make a specific decision. However, particular circumstances, events or behaviours might lead you to question a person’s capacity at a point in time. These are called triggers.

Once you have judged that a trigger exists, a capacity assessment is the next step if all other attempts to solve the problem have failed and the conduct of the person is causing, or is likely to cause, significant harm to the person or someone else. Or if there are important legal consequences of the decision.

Triggers that involve the person’s conduct might include any of the following:      

  • repeatedly making decisions that put the person at significant risk of harm or mistreatment
  • making a decision that is obviously out of character and that may cause harm or mistreatment
  • often being confused about things that were easily understood in the past
  • often being confused about times or places
  • having noticeable problems with memory, especially recent events, and which have an effect on the person’s ability to carry out everyday tasks
  • dramatically losing language and social skills. For example, having difficulty finding a word, not making sense when speaking, not understanding others when they speak, having wandering thought patterns, interrupting or ignoring a person when they are speaking, or failing to respond to communication
  • having difficulty expressing emotions appropriately, such as inappropriate anger, sexual expression, humour or tears without actual sadness
  • displaying sudden changes in personality. For example,excessive irritability, anxiety, mood swings, aggression, overreaction, impulsiveness, depression, paranoia or the onset of repetitive behaviours
  • declining reading and writing skills
  • having difficulty judging distance or direction, for example when driving a car.
    Triggers that involve the person’s circumstances might include:
  • not looking after themself or their home the way they usually do and this being bad for their health or putting them at significant risk. For example, neglecting significant personal concerns such as health, hygiene, personal appearance, housing needs or nutritional needs
  • not paying bills or attending to other financial matters, such as running their business, repaying loans or other debts
    making unnecessary and excessive purchases or giving their money away, and this being out of character
  • noticeably being taken advantage of by others, such as being persuaded into giving away large assets that they still require such as a house, car or savings, or signing contracts that disadvantage them
  • having been diagnosed with a condition that may affect their capacity
  • having lacked capacity to make decisions in the past.

These types of triggers may be noticed by you, or by someone else who is seeking a capacity assessment for the person, or even by the person themself.

Increased capacity

Another important trigger for assessment is when a person’s capacity improves. The person may simply have regained capacity lost through ill health or other circumstances. They may have learnt skills or accessed support services to increase their capacity. A person who could not make their own decisions in the past may now be able to do so if another assessment is conducted.

Mental illness and fluctuation of capacity

If you are dealing with a person whose capacity fluctuates because of a mental illness, it is crucial to make an assessment when there is an indication of increased ability to make decisions. This will enable the person to have control over as many of their decisions as possible.

Case Study

Triggers

‘I have an elderly client, Aja, whom I visit regularly. Lately I have noticed that her car is taking quite a few knocks, different scrapes, dents and marks. This by itself doesn’t worry me, but I have found that she is also repeating herself often and forgetting where she can find common items, like cups and towels, in her home.

As her caseworker I organised a meeting with Aja, her doctor, and her family (after getting her permission,of course!) and we all discussed whether Aja should undertake a test which would help the doctor advise her (and the Roads and Traffic Authority) about whether she should continue driving.

Aja’s family said that they had noticed the forgetfulness too, especially that she was not turning up to planned events and was using words from her native language (Hindi) right in the middle of an English sentence.

On her doctor’s advice after a capacity assessment (at which there was also a neutral interpreter), Aja decided that she should no longer drive.’

Shaun, caseworker


Who might assess capacity?    

Assessors

Different people will be involved in assessing a person’s capacity. Exactly who, depends on the kind of decision and the time at which it is made. It is usually the individual who is directly concerned with the decision-maker when the decision needs to be made, either in their role as a provider of services or as an involved or concerned family member, carer or friend. In NSW a range of people in the community are recognised as having a responsibility to undertake an assessment of a person’s capacity. You may find yourself in the role of a:

  • solicitor, who has an obligation to consider a person’s capacity before acting on instructions about a variety of decisions such as property transactions, civil litigation and future planning
  • professional from the financial sector, who must consider a person’s capacity to give directions regarding their finances and assets
  • medical or dental practitioner seeking consent for treatment from a patient
  • a community worker or other professional, such as a disability or social and allied health worker, who may assess a person’s capacity to make a decision about services
  • member of the community appointed as an enduring guardian, or with an enduring power of attorney stating that it can only commence once a person has lost capacity
  • advocate seeking consent to support a person to express their views
  • family member, friend or carer making informal decisions for a person with a decision-making disability.

The following examples show how you might be involved in assessing a person’s capacity in different circumstances:

  • legal practitioners might assess whether a person has capacity to understand the nature of what they are doing and whether they have the capacity to give the legal practitioner the necessary information to carry out the work
  • bank staff may need to assess whether a person is capable of dealing with their finances
  • doctors or healthcare professionals may need to assess a person’s capacity to decide whether to go ahead with a treatment before they rely on the person’s consent
  • community nurses might assess whether a person can consent to getting an injection or having a bandage changed

Aged Care Assessment Team (ACAT) workers, social workers, family members or carers may need to decide whether a person has the capacity to make the personal decisions necessary to live in their own home.

What if there are still doubts about capacity?

If there are still doubts about a person’s capacity after an assessment, you (or another individual) may want to get a second opinion about the person’s capacity from a general practitioner, a psychiatrist, a psychologist, a geriatrician or a neuro-psychologist, for example. These second opinions could be used, for instance, by a:

  • legal practitioner to decide whether a person has the capacity to make a will or enter into a contract
  • general practitioner to determine whether the patient can understand the nature and effect of a proposed treatment, or if a substitute decision-maker should make the decision
  • healthcare worker to help decide whether a person has the capacity to make a decision about their accommodation arrangements

family member to decide whether to use an enduring power of attorney or guardianship, or to seek the appointment of a financial manager or guardian from the Guardianship Tribunal.

Should I seek a second opinion?

In some situations, a second opinion may be the only way to ensure a fair assessment of a person’s capacity. Factors that may indicate that a second opinion might be necessary are:

  • a dispute by the person concerned, who believes they still have capacity
  • a disagreement between family members, carers,community workers or other professionals about the person’s capacity.

Additionally, as the seriousness of a decision and its consequences increases, the possible need for a second opinion also increases when there is still a question of the person’s capacity to make that decision.

Remember, although getting a second opinion will help, the final decision about capacity is ultimately to be made by whomever it is that needs to know whether the person is capable of making the specific decision. That might be the individual who will be making the decision on behalf of the person (substitute decision-maker), or a community worker or other professional providing a service to the individual. More specific examples are a:

  • family member needing to use a power of attorney
  • lawyer writing an advance care directive
  • bank manager approving a loan
  • doctor assessing capacity to consent to medical treatment.

When there is involvement by the Guardianship Tribunal, the Mental Health Review Tribunal or the Supreme Court then the tribunal or court will make the decision as to a
person’s capacity.

Where a second opinion is unable to be obtained for reasons such as a dispute, urgency, location or lack of finances, the individual disputing the original capacity assessment may need to go to the Guardianship Tribunal or Supreme Court for a decision about a substitute decision-maker.

More Information - Privacy Links

The following government agencies can give you information about your privacy obligations:

Information & Privacy Commission
Ph: (02) 8688 8585
www.ipc.nsw.gov.au

The Office of the Australian Information Commissioner (Federal)
Ph: 1300 363 992
TTY: 1800 620 241
www.oaic.gov.au/

If you belong to a professional association, contact them about the privacy standards that apply within your profession. For example:
Australian Medical Association
Ph: (02) 6270 5400
www.ama.com.au

Australian Healthcare and Hospitals Association
Ph: (02) 6162 0780

http://ahha.asn.au​/

Financial Ombudsman Service
Ph: 1300 780 808
www.fos.org.au/

The Law Society of NSW
Ph: (02) 9926 0333
www.lawsociety.com.au

Real Estate Institute of New South Wales
Ph: (02) 9264 2343
www.reinsw.com.au

If you are a staff member of a government department or an organisation, refer to your agency’s privacy policy or procedure.


More information - Substitute Decision Making

The Guardianship Division of the NSW Civil & Administrative Tribunal can provide more information about the appointment of a substitute decision-maker such as under a power of attorney, a guardian, financial manager or a ‘person responsible’.14 For information about whether  you need to apply for the appointment of a substitute decision-maker go to the website or phone the Tribunal.

Guardianship Division
Toll free: 1800 463 928
Ph: (02) 9555 8500
People who are Deaf or hard of hearing use the national relay service to contact us call: 133 677.

People with speech impairments use the national relay service speak and listen service 1300 555 727.
www.ncat.nsw.gov.au/Pages/guardianship/guardianship.aspx

When the person is a patient in a mental health facility,or a court has referred the matter to the Mental Health Review Tribunal (MHRT) you can get information about the appointment of a financial manager by contacting the MHRT.

Mental Health Review Tribunal
Toll free: 1800 815 511
Ph: (02) 9816 5955
www.mhrt.nsw.gov.au

The NSW Public Guardian  can provide answers to common questions over the phone, or go to the ‘Common questions’ tab on the OPG website. For fact sheets providing general information on guardians and persons responsible, and the Application for Guardianship and/or Financial Management Form, go to the ‘Publications’ tab on the OPG website.

Office of the Public Guardian
Toll free: 1800 451 510
Ph: (02) 8688 6070 (information and support)
TTY: 1800 882 889
www.publicguardian.justice.nsw.gov.au/

The NSW Trustee & Guardian (NSW TAG) may also be able to provide information about the appointment of a financial manager as a substitute decision-maker. On the NSW TAG website, select ‘About us’ and go to ‘How does the Trustee & Guardian become involved?’  Additional information about private managers can be found on the NSW TAG website if you select ‘Private management’ and then click on ‘About private managers’.

NSW Trustee & Guardian (NSW TAG)
Ph: (02) 8688 2600
Toll free: 1300 360 466
People who are Deaf or hard of hearing use the national relay service to contact us call: 133 677.

People with speech impairments use the national relay service speak and listen service 1300 555 727.
www.tag.nsw.gov.au/

Solicitors can give you information and advice about substitute decision-makers. The Law Society of NSW has a list of solicitors on its website. Click on ‘Advance find a lawyer search’. Or ring the ‘Solicitor Referral Service’ at the Law Society of NSW.

Law Society of NSW
Ph: (02) 9926 0300
Toll free: 1800 422 713
www.lawsociety.com.au

LawAccess NSW is a free government telephone service that provides legal information, advice and solicitor referrals for people who have a legal problem in NSW.

LawAccess NSW
Ph: 1300 888 529
People who are Deaf or hard of hearing use the national relay service to contact us call: 133 677.

People with speech impairments use the national relay service speak and listen service 1300 555 727.
131 450 Telephone Interpreter Service www.lawaccess.nsw.gov.au/

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