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Is there such a thing as too much protection? According to many aged care and disability rights advocates, yes. While those working to support others have a duty of care towards their clients, this needs to be balanced with the right of individuals to make decisions about their own life that could expose them to potential harm. It’s called dignity of risk, and it’s an essential human right.
What do we mean when we talk about the dignity of risk?
It’s a term that’s not often discussed, but a concept any parent will be familiar with. Parents are constantly making decisions about whether to allow their children to do something that might end up hurting them. Any time they allow them to ride a scooter or catch a bus on their own, parents allow for a certain element of risk. But it’s a decision that’s countered with the understanding a child needs to grow, try new things and learn to deal with adversity when it occurs. It’s also countered with safeguards.
These are the training and risk management strategies put in place whilst someone is building their capacity. It could be as simple as ensuring furniture edges are not sharp when children are learning to walk to putting limits on credit cards to limit overspending when someone has challenges with their spending.
This balancing act emerges in any setting where an individual relies on others to support them. In this article on My Disability Matters, a parent of a young adult with autism talks about the challenges she faces in letting go and allowing her child to make those decisions for himself as he enters adulthood. She uses the example of a parent who supports her son’s decision to pursue a career in a field they feel he may not be suited to. In our desire to protect;
“We may, however, severely limit their ability to make choices, to risk failure, and to grow.”
Our right to take risks doesn’t diminish with age
Nick Ryan, the Chief Executive Officer of the Australian Aged Care Quality Agency states that “Older people receiving aged care services have the same rights as any person to full and effective use of his or her personal, civil, legal and consumer rights. This is underpinned by the presumption that all adults have the right to make decisions that affect their life and to have those decisions respected. The presence of cognitive impairment is not a reason to exclude someone from decision-making”
This article in the Guardian reflects on the dignity of risk as a common theme emerging from the current Aged Care Royal Commission, specifically in a residential care setting;
“The tension between allowing residents small freedoms that add to their quality of life versus a bureaucratised risk aversion in nursing homes.”
In the piece, the journalist uses the example of a client with dementia who enjoyed garden walks, but was confined to a locked ward for his own safety. In this instance, the decision was made to restrict his outdoor access despite his wife granting permission, expressing her belief that ‘his quality of life is more important than his safety.’
But when you’re responsible for the wellbeing of another person, how do you meet your duty of care while still allowing them the freedom to take reasonable risks – a freedom that’s essential to their dignity and independence?
What’s considered a reasonable risk?
As a word, ‘risk’ is laden with negative connotations. But there’s actually risk inherent in most things we do. Risk is a part of life. It’s in our choices about the foods we eat, the activities we undertake, and our basic lifestyle choices. The idea behind dignity of risk is that the ability for individuals, or their loved ones, to make choices about their life is more important than avoiding risks at all costs. That doesn’t mean we can’t work to minimise those risks. As explored in this article on Australian Ageing Agenda, it’s important for anyone providing support services to strike a balance between valuing consumers’ rights to exercise control, while fulfilling their own responsibilities. Here at Mable, we know the idea of ‘community care’ is increasingly outdated. Our clients don’t want to be cared for. They want to be supported to live their lives. That’s why our model, where clients search for and directly engage independent support workers, works so well. Clients using the Mable platform are in complete control, making decisions about their support. But just because clients who use Mable are making their own decisions about their support, doesn’t mean there aren’t appropriate protections for clients using our platform.
Reasonable risks’, with appropriate protections in place
At Mable, we put in place a framework that includes important protections and safeguards, and it’s within this framework that clients make decisions about their support. At Mable, these protections and safeguards include:
- A high-level suite of insurances arranged on behalf of all independent workers for engagements invoiced via the platform, which are specially designed to protect consumers and their independent workers.
- A support team based in Sydney to provide users of the Mable platform tips on getting started.
- Our strict onboarding process for independent workers.
- Periodic checks and community reviews of workers who use the platform.
Dignity of risk is not only about choice, it’s also about someone’s right to fail, or to make mistakes. Here at Mable, we know that not every match made on the platform will be an immediate success. When a client engages an independent support worker, many things can factor into that decision – that support worker’s experience and skills, their personality, or other assets that might make them a good match. If an engagement between a client and their chosen worker is not working out, they have the ability to end that engagement and look for someone new. This consumer choice is a hallmark of Consumer Directed Care and the NDIS.
Are you interested in having more control over support you engage for you and your family? Find out more about how you can use your funding to directly engage independent support workers via Mable.
The legal right of every person, including those with disability, to make choices and take risks so they may grow, learn and have better life quality.
An older person may wish to continue living in their two-storey house, despite the risk of falls while using the stairs.
An older person may wish to walk to their local shopping centre, despite the reasonable risks of traffic, potential trip hazards and wet weather.
Positive risk involves assessing risks and ‘what-ifs’ while planning an activity, to identify ways of minimising potential challenges. For example, if an aged care client wishes to go to the cinema, positive risk may involve the client has a voucher for taxi usage to avoid the need for public transport, or ensuring the client has a mobile phone they know how to use with location tracking, so their family knows they can keep in touch if necessary.
Risk is always constant in life, however positive risk taking may help clients experience activities and exercises which they otherwise may have been unable to. Collective consultation with those involved in support clients can ensure appropriate precautions are taken to make the most of the client’s abilities to help achieve their goals.