title: An Evaluation of the Decision-Making Capacity Assessment Model.
abstract: BACKGROUND
  The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted.
  
  
  METHODS
  A mixed methods approach was used. Survey (N= 126) and focus group (N= 49) data were collected from practitioners utilizing the Model.
  
  
  RESULTS
  Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model's guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation.
  
  
  CONCLUSIONS
  The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted.
authors.affiliation: Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton.
authors.forename: Suzette C
authors.initials: SC
authors.lastname: Brémault-Phillips
authors.affiliation: Department of Family Medicine, University of Alberta, Edmonton;; Home Living, Edmonton Zone Continuing Care, Edmonton;; Covenant Health Network of Excellence in Seniors Health and Wellness, Edmonton.
authors.forename: Jasneet
authors.initials: J
authors.lastname: Parmar
authors.affiliation: Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton;; Bethany Care Society, Calgary, AB.
authors.forename: Steven
authors.initials: S
authors.lastname: Friesen
authors.affiliation: Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Rogers
authors.affiliation: Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton.
authors.forename: Ashley
authors.initials: A
authors.lastname: Pike
authors.affiliation: Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton.
authors.forename: Bryan
authors.initials: B
authors.lastname: Sluggett
keywords: capacity; capacity assessment; capacity assessment model; cognitive decline; competency; decision-making; evaluation; older adults