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Get a Decision-Making Capacity Evaluation

Nurse On Board is proud to collaborate with the Capacity Clinic to address one of the most critical and often misunderstood challenges in community care: decision-making capacity evaluation.
Historically, capacity has frequently been assessed in a subjective manner by professionals across various disciplines, sometimes using tools that do not fully reflect an individual’s ability to manage their everyday needs. This inconsistency is partly due to a longstanding gap in capacity literacy in Canada, an issue now being actively addressed by the Canadian Centre for Decision-Making Capacity.

Nurse On Board is deeply committed to supporting the autonomy and rights of individuals, whether or not they are our clients. Community care is strengthened, and decision-making becomes clearer and more collaborative, when individuals and/or their Substitute Decision-Makers are aligned through DecisionTracker™ insights and meaningful, informed conversations.

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Supporting autonomy. Protecting safety. Guiding Substitute Decision-Makers.

People are not always aware when their ability to make decisions may be affected. Changes in health, cognition, or life circumstances can quietly increase the risk of harm, often before a person realizes support is needed.

DecisionTracker™ is a structured incapacity-monitoring service offered by Nurse On Board, using a tool developed by Capacity Clinic, to help identify when decision-making support may be needed and when it is not.

DecisionTracker™ is not a legal or medical capacity assessment. It is a professional service designed to identify risk, support autonomy, and guide next steps.

Nurse On Board offers this service to our clients who need our support with health care, and as a stand-alone evaluation for those who recognize the need and value of DecisionTracker™.

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What Is DecisionTracker™?

DecisionTracker™ is a structured monitoring process that helps determine whether:

• a client continues to understand key information related to their life and care, or
• decision-making may be compromised in specific areas

The assessment focuses on how a person understands and makes decisions related to:

• health care
• mental health
• housing
• relationships
• finances

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If a client does not understand important information, this does not mean they are incapable of making all decisions. Instead, it identifies where understanding may be limited and where additional support may be needed.

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What Is Decision-Making Capacity?

Decision-making capacity is the ability to:

• understand relevant information, and
• appreciate the possible outcomes of a decision

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Capacity is decision-specific, situation-specific, and time-specific. A complex diagnosis, hospitalization, or advanced age does not automatically mean a person lacks capacity, but it may signal the need for closer monitoring.

Who Is DecisionTracker™ For?

• Existing Nurse On Board clients with evolving health or cognitive concerns
• Individuals or families concerned about decision-making capacity
• Substitute Decision-Makers (SDMs) seeking guidance on when to step in, and when not to
• Professionals supporting clients with complex medical, social, or financial decisions

​This service can be used with or without ongoing Nurse On Board care management, depending on the client’s needs.

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How DecisionTracker™ Protects You:

• supports autonomy for as long as decision-making remains intact
• identifies concerns early, before serious risks arise
• ensures SDMs are involved only when appropriate
• provides clear documentation and professional nursing oversight

How DecisionTracker™ Protects Substitute Decision-Makers (SDMs):
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• offers guidance on when to step in — or step back
• reduces uncertainty, conflict, and emotional burden
• supports decisions made in good faith and in the client’s best interests

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This process helps SDMs feel confident that they are acting at the right time, for the right reasons, with professional support.

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Important to Know
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• DecisionTracker™ does not replace a formal capacity assessment
• It is a monitoring and risk-identification tool, led by experienced Registered Nurses
• The goal is timely, proportionate, and respectful support, not premature loss of autonomy

Additional information available through this presentation offered by Nurse On Board in July 2025-  "Capacity Evaluations and Community Care: What's Really Going On?"

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Learn More or Get Started

To learn whether DecisionTracker™ is right for you or someone you support, contact Nurse On Board to speak with a nurse.

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Range of Services

Nurse On Board has the right Nurse Care Manager with the experience to address your specific needs and your situation. See the range of services we provide.  Read more.

Your Registered Nurse

What will your RN be able to do for you? That's based on your specific and sometimes unique needs. You may be surprised at how adept our Care Managers are in getting what's best for you. Read more.

Corporate Care

​A range of Nurse On Board services are available for retirement residences and seniors' communities, to support individuals in both independent and assisted living environments. Read more.