Assessing Decision-making Capacity in Persons with Aphasia

DESCRIPTIONAssessing Decision-making Capacity in Persons with Aphasia. Life-altering decisions often mark and significantly shape a patient’s rehabilitation process. The complex choices patients, families and rehabilitation clinicians face frequently give rise to profound ethical considerations, particularly around the question of who should ultimately make these important decisions. At the crux of such dilemmas lies an important question: does the patient have decision-making capacity (DMC)? Although there is no definitive test, DMC is typically evaluated using a semi-structured interview approach that assesses patients’ alertness, orientation, ability to communicate a choice, understanding of relevant information, appreciation of the situation and ability to rationally manipulate information. However, aphasia presents a significant challenge to DMC assessment as persons with aphasia commonly experience impairments in comprehension and expression that can interfere with the exchange o