Practicing clinicians are inherently faced on a daily basis with capacity decisions which usually do not rise to the level of a court determined decision on competency. This presentation will examine the ethical aspects of and core components of capacity. The practical means of determining individual capacities and the literature regarding the strengths and weaknesses of neuropsychological tests in relation to common capacities will be discussed. An examination of how risk affects the sliding scale of decision making will be presented with a particular focus on how risk reduction can be an effective means for mitigating possible incapacity. Common questions regarding the capacity for daily activities such as driving, independent living, and medication management in an adult population and how neuropsychological evaluations can aid in this process will be reviewed. Ultimately, methods for avoiding the legal determination of incompetency in a variety of possible capacity decisions will be presented as a goal and the skills needed to attain this outcome, be they through remediation, accommodation, or a reduction in risk, will be highlighted.

Learning Objectives
At the end of this presentation, learners will be able to:
1. Describe the four core components needed to evaluate capacity.

2. Describe the two views on the determination of the sliding scale of capacity and the pros/cons for each.

3. Discuss how risk affects the sliding scale of capacity and ways to reduce risk.

4. Describe the various challenges that clinicians face when using neuropsychological tests to determine individual capacities.

Instructional Level: Intermediate
Target Audience: Neuropsychologists

Dr. Ruchinskas is board certified (ABPP) in both Clinical Neuropsychology and Rehabilitation Psychology and is a Fellow of both the American Psychological Association and the National Academy of Neuropsychology. Dr. Ruchinskas' clinical expertise is in the area of neuropsychological assessment, with particular interest in working with individuals who have dementia. His research interests focus on differentiating normal from abnormal aging, ethical issues in aging, and coping with chronic diseases.