Financial Capacity Assessment

A Financial Capacity Assessment should be done when there is concern that an individual could be incapable of managing their finances in the context of a psychiatric (e.g. - spending during a manic episode in bipolar I disorder) or neurocognitive disorder (e.g. - dementia).

In the Province of Ontario

A Form 21 (Certificate of Incapacity to Manage One’s Property under Subsection 54(4) of the Act) is issued when a patient is deemed incapable to manage one's finances (property). When a Form 21 is filled, a concurrent Form 33 must be given to the patient to notify them of this finding.

When doing a financial capacity assessment, first inform the patient the purpose of the assessment, and possible outcomes of the assessment explicitly explained to them. A financial capacity assessment tests the patient's ability to understand and appreciate the consequences of their financial decisions.

  1. What is your source of income? What is your monthly income?
  2. What are your current savings?
  3. Do you have any assets or debts?
  4. What are your monthly expenses?
  5. Ask patient to identity the costs of basic consumer items and services (are they able to provide estimates?)
  6. Ask your patient a basic calculation question (document: are they able to answer?)
  7. Ask your patient to add up their monthly fixed expenses to figure out how much total spending they will have each month (are they able to do this accurately?)
  8. Ask them to determine how much money is left over after these fixed expenses (are they able to estimate their monthly left over savings?)

Sample Documentation of Financial Capacity Assessment

Based on the financial capacity assessment today, there [IS/IS NOT] indication that: patient has defaulted on rent payment or other bills, patient is unable to save money, patient has [psychiatric symptoms: e.g. - delusions] informing their financial decisions.

Patient is CAPABLE/NOT CAPABLE to manage own finances.

Pearls

  • If a patient appeals your finding of incapacity, the actual monetary amount that the patient can spend does play a significant role on how the Consent and Capacity Board rules on physician's finding (i.e. $400 vs. $4 million)
  • Inpatients who are assessed as financially incapable must be given rights advice before they are discharged.
  • Patients who are not admitted and are outpatients cannot be deemed financially incapable UNLESS they themselves first consent to a financial capacity assessment
    • Thus, getting a financial capacity assessment can be very difficult in an outpatient setting