What is dignity of risk and why does it matter?

Aged Care, Disability August 14, 2019

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?

t’s a term that’s not often talked about, but it’s a concept that any parent will be familiar with. Parents are constantly making decisions about whether to allow their child to do something that might end up hurting them. Any time they’re allow them to ride a scooter, or catch a bus on their own, parents are allowing for a certain element of risk. But it’s a decision that’s countered with the understanding that a child needs to grow, to try new things and to 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 card to limit overspending when someone has challenges with their spending. 

This balancing act emerges in any setting where an individual is relying on others to provide them with support. 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 that 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 the choices we make about the foods we eat, the activities we undertake, as well as 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 that the idea of ‘community care’ is increasingly out of date. 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 who use the Mable platform are in complete control, making decisions about their own support. But just because clients who use Mable are making their own decisions about their support, doesn’t mean there aren’t appropriate protections in place 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 it’s within this framework that clients make decisions about their support. At Mable, these protections include;

  • 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 is going to be an immediate success. When a client engages an independent support worker, there are lots of things that 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 both 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.