‘Nothing ventured, nothing gained’: risk management for people with dementia

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We all face risk in our lives and regularly make judgements about the risks and benefits of our everyday actions. People with dementia often find their opportunities to make these decisions are restricted because of overly cautious approaches to risk. Professor Jill Manthorpe FAcSS and Jo Moriarty of the Social Care Workforce Research Unit at King’s College London were asked by the Department of Health to produce guidance based on published research that could be used by health, social care and housing professionals, families, and people with dementia.

A summary of the available research showed that people with dementia, family members, and health and social care practitioners often had different ideas about risk. While some topics, such as driving or financial abuse, had been comparatively well researched, there was less material about other situations such as deciding if it was safe to leave a person with dementia on their own in the house.

The researchers also discussed the problem with people interested in the topic, including other researchers, practitioners, policymakers, family carers, and people with dementia. From this the research team produced a simple ‘heat map’ based on balancing the contribution a particular action could make to individuals’ quality of life against its risk of causing harm or reducing their quality of life.

The research programme resulted in Department of Health guidance: ‘Nothing Ventured, Nothing Gained’: Risk Guidance for people with dementia, with associated training packages, including adaptation for people with a learning disability living in care homes or supported living. The guidance is formally supported by various organisations, including Alzheimer’s Society, the British Association of Social Workers and the Royal College of Nursing, and extracts are widely used in local protocols for risk enablement.

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