Positive risk taking relies heavily on a strengths-based approach. This means we need to see people in terms of their strengths, their personal qualities, abilities, capabilities, desires, motivations and wishes. This requires drawing on their past as well as their current situation, and future priorities. It is ultimately about enabling people to live with as much dignity as possible. Understanding that their identity is ‘who they are ‘and ‘what they can do’, NOT ‘what they are’ and ‘what they can no longer do’.
A shared decision-making approach to positive risk taking should be:
Being proactive in terms of risk management is essential to avoid an overly cautious, or risk averse approach compared to a defensible decision. A defensible decision is one where:
Things will occasionally go wrong. All of us – family, friends, services and media need to acknowledge that this happens in all of our lives. Fear and blame are not helpful, particularly if the original decision and subsequent actions were reasonable.
Meaningful Care Matters has developed a Risk Framework Tool for People with Impaired Decision-Making Capacity. This is a good practice guide, using evidence from research on risk and ideas about current best practice and is subject to further review. It is based on identifying and balancing the positive benefits of taking risks against the risks of an adverse event occurring. This framework starts by looking at the benefits for people of doing an activity, and then looks at the risks involved. It also explores the emotional consequences of people not being permitted to do the things which bring love, comfort and joy into their lives. In this way, the best results for the person with impaired decision making will be achieved. It is the responsibility of any services or individuals to ensure they meet both statutory and organisational requirements.
In the next and final section we put what we have learnt into practice through examining 2 case scenarios. Here you will have an opportunity to use MCM’s Risk Framework Tool and debrief your findings. Take some time now to read and respond to the case scenarios and debriefing questions included with this package.