Risk Assessment and Management for Living Well with Dementia

129 Pages·2011·0.42 MB·English

by  Charlotte L Clarke, John Keady, Heather Wilkinson, Catherine E. Gibb

Risk Assessment and Management
for Living Well with Dementia
Bradford Dementia Group Good Practice Guides
Under the editorship of Professor Murna Downs, Chair in Dementia Studies at
the University of Bradford, this series constitutes a set of accessible, jargon-free,
evidence-based good practice guides for all those involved in the care of people
with dementia and their families. The series draws together a range of evidence
including the experience of people with dementia and their families, practice
wisdom, and research and scholarship to promote quality of life and quality of
care.
Bradford Dementia Group ofer undergraduate and post graduate degrees
in dementia studies and short courses in person-centred care and Dementia Care
Mapping, alongside study days in contemporary topics. Information about these
can be found on www.bradford.ac.uk/health/dementia.
other titles in the series
Enriched Care Planning for People with Dementia
A Good Practice Guide to Delivering Person-Centred Care
Hazel May, Paul Edwards and Dawn Brooker
ISBN 978 1 84310 405 6
Person-Centred Dementia Care
Making Services Better
Dawn Brooker
ISBN 978 1 84310 337 0
Ethical Issues in Dementia Care
Making Difcult Decisions
Julian C. Hughes and Clive Baldwin
ISBN 978 1 84310 357 8
of related interest
Rights, Risks and Restraint-Free Care of Older People
Person-Centred Approaches in Health and Social Care
Edited by Rhidian Hughes
Foreword by Baroness Greengross
ISBN 978 1 84310 958 7
Risk Assessment and
Management for Living
Well with Dementia
Charlotte L. Clarke, Heather Wilkinson,
John Keady and Catherine E. Gibb
Foreword by Professor Murna Downs
Jessica Kingsley Publishers
London and Philadelphia
Contains public sector information licensed under the Open Government Licence v1.0.
Table 2.1 from Clarke and Heyman on p.26 us adapted by permission of Hodder Education.
Table 4.1 from Manthorpe and Moriarty 2010 on p.89 is adapted by permission of Jill Manthorpe.
Figure 4.1 from Manthorpe and Moriarty 2010 on p.90 is reproduced by permission of Jill Manthorpe.
Figure 5.2 from Clarke and Gardner 2002 on p.102 is reproduced by permission of Hawker
Publications.
First published in 2011
by Jessica Kingsley Publishers
116 Pentonville Road
London N1 9JB, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.jkp.com
Copyright © Charlotte L. Clarke, Heather Wilkinson, John Keady and Catherine E. Gibb 2011
Foreword copyright © Murna Downs 2011
All rights reserved. No part of this publication may be reproduced in any material form (including
photocopying or storing it in any medium by electronic means and whether or not transiently
or incidentally to some other use of this publication) without the written permission of the
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Library of Congress Cataloging in Publication Data
Risk assessment and management for living well with dementia / Charlotte L. Clarke … [et al.].
p. cm.
Includes bibliographical references and index.
ISBN 978-1-84905-005-0 (alk. paper)
1. Dementia--Patients--Care. 2. Decision making. 3. Risk
management. I. Clarke, Charlotte L. (Charlotte Laura)
RC521.R49 2011
616.8’3--dc22
2010044477
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN 978 1 84905 005 0
ISBN pdf eBook 978 0 85700 519 9
Contents
Foreword by Professor Murna Downs 7
Part I IntroductIon
Chapter 1 Key Issues in Risk and Dementia Care 11
Introduction 1
Living and risk 12
Living well with dementia 14
Our background 18
Principles and aim 19
Part II dIfferent VIews on rIsk
Chapter 2 Living with Dementia: Living with Risk 23
Introduction 23
Perceptions and difering views 23
Dementia care and risk in developing countries 29
The views of people with dementia and carers 34
Everyday life 46
Sumary 51
Chapter 3 Working with Dementia: Working with Risk 53
Introduction 53
Risk in dementia care practice 53
Risk dilemmas 56
Legislative framework 60
Balancing risk assessment 61
Sumary 74
Part III rIsk and Your PractIce
Chapter 4 Risk Management 79
Introduction 79
The importance of process 81
Risk framework 83
Risk communication 86
Risk assessment and management framework 88
Sumary 92
Chapter 5 Developing Practice in Risk Management in
Dementia Care 93
Introduction 93
Revisiting our key messages 93
Risk in promoting quality of life 96
Professional development and decision making 98
Changing society – matters of value 103
Future directions 106
Conclusion 110
Appendix 113
References 117
Subject Index 123
Author Index xxx
Foreword
Risk Assessment and Management for Living Well with Dementia could not
be more timely. Living well with dementia is now a priority for the
Department of Health in England as indeed it is throughout most
of the world. Living well for all of us requires that we identify and
negotiate risks in our lives. As such, risk management is central to
wellbeing and quality of life. We are encouraged to think of risk not
as something to be avoided and from which we need to shy away,
but rather as something integral to wellbeing which needs to be
embraced and actively managed. Risk is not an abstract and unitary
concept which we wish to remove, but a complex and continually
negotiated aspect of all of our lives.
In Risk Assessment and Management for Living Well with Dementia we
are reminded that risk looks diferent from diferent perspectives and
that these perspectives in turn are informed by diferent knowledge
bases. While professionals and practitioners may have one view of
risk, family members may have another and people with dementia
will, in turn, have their own perspective. This guide challenges
us to address the complexity of diferent understandings of, and
perspectives on, risk. It provides helpful guidance on how we might
reconcile our perspective with other perspectives, most notably those
of people with dementia. As such, the authors encourage us to take
as our starting point in risk management the perspective and needs of
people with dementia. By grounding this contemporary good practice
guide in the experience of four people with dementia, Risk Assessment
and Management for Living Well with Dementia illustrates how we need
to ground our concern with risk assessment and management in the
7
8  Risk Assessment and Management for Living Well with Dementia
context of the person’s life – their life history, family circumstance,
and social and cultural context.
Risk is not only integral to our personal lives and day-to-
day wellbeing but also to professional practice. Risk Assessment and
Management for Living Well with Dementia discusses dilemmas present
in our day-to-day professional practice and ofers a basic legislative
framework within which to consider our everyday practice. The guide
stresses that successful resolution of risk dilemmas in dementia care
requires the inclusion of the perspective, needs, rights and entitlements
of people with dementia.
Usefully portraying risk assessment and management from two
main perspectives – that of people with dementia and their family
members, and that of managers and practitioners – the authors provide
a risk framework for dementia which focuses on the following four
elements:
• identifying the risks in the context of the person’s biography
and life history
• identifying the risks to the various stakeholders, including
professionals, practitioners, family and the person with
dementia
• weighing the diferent risks involved
• identifying current and past strategies for managing risks.
In summary, Risk Assessment and Management for Living Well with Dementia
raises a range of contemporary issues and concerns which require our
attention. It not only raises these issues and concerns, however, but
also proposes a clear way forward for person-centred risk assessment
and management seeking to reconcile the difering perspectives of
practitioners, family members and people with dementia.
Professor Murna Downs,
Series Editor of Bradford Demential Group Good Practice Guides
University of Bradford
14 March 2011
Part I
IntroductIon