What is ‘Dignity of Risk’ in Aged Care?

The concept or rather the necessity of ‘dignity of risk’ was perfectly summarised by Joseph E Ibrahim, Head of Health Law and the Ageing Research Unit at Monash University.


‘Dignity of risk’ refers to the concept of affording a person the right (or dignity) to take reasonable risks, and that the impeding of this right can suffocate personal growth, self-esteem and the overall quality of life (Ibrahim & Davis 2013).

There are steps that a carer must take in evaluating the dignity of risk; Is the individual present of mind? Do they have access to all information required to make informed decisions about the risk? Could it impact others? And, should a GP or family member be consulted on the decision?

We’ll discuss the elements of approaching dignity of risk, and assessing situations, alongside exploring the similarities, differences, and conflicts between ‘dignity of risk’ vs ‘duty of care’.

What is ‘Dignity of Risk’?

In life, we’re confronted with the decisions and pathways that contribute to developing our personalities, teaching us valuable lessons, and guiding us towards improving and developing our quality of life. The freedom of choice and resilience post-failure inspires and motivates us to strengthen our weaknesses and hone our skills.

Without this freedom, we become complacent, dependent, and restricted. And this is no different in aged care. Individuals require dignity of risk, but there are precautions that a carer must take to ensure that the individual is capable of making the decision and handling the outcomes in reference to their health and safety and that of others.

According to Monash University’s 2017 study on the ‘dignity of risk’, there are clear attributes of what outlines positive risk-taking and over-protection.

Positive Risk-taking

Positive risk-taking could;

  • Improve autonomy
  • Improve social interaction  
  • Improve health 
  • Improve Independence 
  • Correlate with their values and personality  
  • Develop self-determination and feelings of worth 

Over-protection

Over-protection could;

  • Patronise
  • Smother 
  • Remove hope
  • Diminish 
  • Stifle potential and self-expression

Understanding the Individual’s Dignity and Choice

It’s crucial to remember that no two individuals have the same life experience. We all come from diverse backgrounds, cultures, and walks of life, creating the necessity of flexible care and individual, regular assessment.

According to the Australian Government’s consumer dignity and choice standard, seven elements comprise the scope of an individual’s dignity and rights in aged care.

Dignity and Respect

Treating individuals with respect fosters communication and motivation, allowing them to grow and learn in all areas, ultimately improving the quality of life.

Identity, Culture, and Diversity

Individuals must be shown equality. Carers must be accommodating of religious practices and understanding of language barriers with measures in place to mediate requests and communication. Respecting an individual’s identity, culture, and diversity is understanding their needs and preferences.

Cultural Safety

Receiving tailored treatment and services that are carefully constructed around their identity, culture, and diversity.

Freedom of Choice

A provider must accommodate and encourage choice. And to strengthen this offering, they must provide options and services that correlate with the choices and make them accessible to the individual by any means necessary (within reason).

Dignity of Risk

An individual requires dignity of risk. The provider has a responsibility to inform the individual of the repercussions and risks associated with their decision and actions.

Taking risks, failing, accomplishing, and learning contribute to the betterment of the individual’s mental frame of mind and their overall quality of life.

Information

Individuals have a right to access information on their care plan, services, costs, and personal information. Information must be communicated in a manner that is clear, understandable, and tailored to the individual’s needs and abilities. People learn and process differently and it is a carer’s responsibility to customise their approach when handling direct correspondence and relationships.

Personal Privacy

All individuals have a right to personal privacy. Over-caring for someone, stepping on boundaries and personal space can stifle the individual’s independence and growth. 

The confidentiality of an individual’s personal information must be protected, and remain accessible to them at all times.

Duty of Care

A duty of care in aged care is the legal obligation on a staff member or organisation to act in the best interests of residents. Duty of care laws are designed to protect all Australians, especially those who may be disadvantaged or receiving medical treatment and/or service.

Dignity of Risk vs Duty of Care

For many years dignity of risk vs duty of care has been analysed and studied as many agree that there are contradictions and conflicts around their core principles.

Carers have a duty of care to ensure the safety of all individuals and that of their own. In addition, carers must show individuals the dignity of risk. So, it is apparent that the conflict starts and ends with providing safety and cultivating risk and decision making. 

There are factors that a carer must address in approaching dignity of risk if there are certain hazards that may encroach on liability and safety – ultimately reshaping the boundaries of their duty of care.

The following factors must be addressed:Is the individual aware of the implications and repercussions of the risk?

  •  a carer must offer guidance alongside detailed information on the risks associated with the individual’s decision. This must be documented as a reference if such hazards do in fact eventuate.

Are they present of mind to make the decision?

  • A carer must consult a GP and/or family members to discuss whether the individual is present of mind and is capable of making such decisions that could incur failure or harm.

Is the risk harming others?

  • A carer must evaluate whether the individual’s decision may impact others at the aged care facility including staff. If so, a carer has the right to decline their request, acting on their duty of care for all individuals and employees at the aged care facility. 

Will the individual’s decision seriously impact their safety?

  • A carer must consider whether their decision may result in death or permanent injury. If so the carer has a duty of care to decline their request.

If a carer declined a request they must offer a detailed explanation informing the individual as to why their request was denied. Showing individuals respect through communication and compassion is absolutely imperative. Offering a solution or compromise is the best way to approach the situation.

If the individual’s best interests are at heart, the dignity of risk cannot contradict a carer’s duty of care. By nurturing their learning and independence whilst coordinating their safety through education and guidance, a carer can find an equilibrium.

Heritage Care

We ensure that staff, from carers, facility workers, nurses and cleaners manifest a compassionate approach holding their duty of care of the utmost importance. We encourage and cultivate independence showing individuals the dignity of risk that they deserve.

Want to talk to a professional? Get in contact with one of our team members for more information – Contact Heritage Care.