Learning Paper on Dementia and Risk
This learning paper from Genio describes current challenges of risk assessment and risk management in dementia care and draws on the contributions of participants in a workshop organised by Genio. It is divided into two parts: understanding risk; and positive risk-taking and quality of life. In the first part, it explores the concepts of risk, both from objective and subjective perspectives and distinguishes it from harm. Where risk is located is important, and the paper argues that by managing environments rather than seeing people as inherently problematic, people with dementia can be supported to take risks that enhance their quality of life. The paper groups the risks and associated dilemmas that people with dementia have under five headings: harms, self-neglect and antecedent activities; vulnerability to the action of other people; stigma and being socially isolated/excluded; lack of continuity of usual activities; and carer unable to sustain caring. The paper promotes a risk enabling approach which offers the opportunity to attend to safety, welfare and quality of life. It offers different ways of working with risk. It also looks at what are referred to as ‘silent harms’ and how they might be prevented. It sets outs principles that can be followed by practitioners in accessing risk, and reminds us that this is just one part of the cycle of risk management. Finally, it outlines risk assessment frameworks that can be used in practice accompanied by examples.