Getting Savvy about The Dignity of Risk

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We may wonder what Dignity of Risk really means, but one of the clearest definitions of “Dignity of Risk” is what Christopher Lyons, Senior Director and Counsel at AIM Services comes up with.

https://qorf.org.au/what-is-the-dignity-of-risk/

He writes that it is “The right to take risks when engaging in life experiences, and the right to fail in taking these.”

He also notes that the term “Dignity of Risk” originated around from care for people with intellectual disabilities back in the 1970’s. At that time, people with intellectual or developmental disabilities were often viewed as incapable of living independently or making decisions for themselves. And this view often deprived them of many typical life experiences that others take for granted.

After all this time, the new aged care standards, in transition from 1 July 2018, have now embedded the Dignity of Risk principle in a foundation standard 1. It’s no surprise that this principle, dating back to the disability sector, is well-suited to the care of older adults.  And now this standard applies to aged care providers of both residential and home care.  https://www.agedcarequality.gov.au/providers/standards/standard-1

Standard 1 includes a consumer outcome of maintaining identity. That “the right of consumers to make their own decisions about their care and services, as well as their right to take risks”, is now well and truly on the table. It intersects with the vital recognition of the consumer’s sense of self and being able to act independently.

The Government takes the view that making choices and taking part in the community underpin the social inclusion, health and well-being of a consumer in an aged care service. We respect a consumer by affording them the dignity of risk-taking, which is an essential ingredient in a quality of life matrix.

The most sensible perspective on The Dignity of Risk is one that acknowledges that life experiences actually come with risk. And with that in mind, we must support people in experiencing success and failure throughout their lives. However, the balancing act comes when we want to support decisions that we have deemed as risky, or with which we don’t agree, with safety-oriented considerations.

But the government has thought about that. The standard states “organisations need to take a balanced approach to managing risk and respecting consumer rights. If a consumer makes a choice that is possibly harmful to them, then the organisation is expected to help the consumer understand the risk and how it could be managed. Together, they should look for solutions that are tailored to help the consumer to live the way they choose.”

The Monash University’s Dignity of Risk Project mentions some crucial facilitators to make this work in aged care service provision. https://www2.health.vic.gov.au/~/media/Health/Files/Collections/Presentations/S/Striving-For-Care-Excellence/Exploring-the-concept-of-Dignity-of-Risk

 One idea that seems central is that we need to change the perspective of aged care as health provider to that of aged care social provider. They include organisational change that has clear processes and protocols, staff training and support and capacity to understand a consumer’s values and to collaborate with the individual concerned.

But all the same, dignity of risk means that there has to be a balance between an organisation’s duty of care and the consumer’s right to decide what level of risk they would be comfortable with.

The hard fact is that we are swimming in risk. We live in the world, not in a bubble. Crossing the road is a risk. Then walking the footpath is a risk. Eating peanuts can be a risk. 

Yet, when the sunset is brilliant, with the sky flooded in vivid, pink clouds, we might say to ourselves, “A red sky at night is a shepherd’s delight!” And we rush outside out on our balcony to take in the experience of it. We don’t think of the risk of falling off our balcony. The inspiration of nature is not to be missed. On the other hand, we might close the curtains and slink back to a cup of cold tea and a rerun of Hogan’s Heroes. We might comfort ourselves with, “but I am worried. Red sky in the morning is a shepherd’s warning.” We ask ourselves what we have gained. And it could be a whopping dose of tedium. That, surely, is bad for our health. 

To be followed by next piece The Big Shift towards Dignity.

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