How should a social worker address clients with limited decision-making capacity?

• A. Deny services to clients with limited decision-making capacity.
• B. Assess capacity, involve guardians as appropriate, and use supported decision-making strategies.
• C. Ignore capacity concerns.
• D. Proceed with decisions without client input.

Answer: (B)

The key idea is to work with clients who have limited decision-making capacity by evaluating capacity for each decision, strengthening their ability to participate through supports, and bringing in guardians or surrogates only when necessary. Capacity is task- and time-specific, and people can often participate meaningfully if information is clear, options are presented simply, and supports are provided. Supported decision-making helps the client stay engaged in choices by using plain language, repeating or rephrasing information, offering decision aids, and involving trusted supporters chosen by the client. If guardianship or a surrogate is needed, it should be used to protect the client while still prioritizing the least restrictive option and regularly reassessing capacity. Denying services or ignoring capacity, or making decisions without the client’s input, undermines autonomy and can cause harm.