Risk and dementia

The effects of dementia on people's ability to make decisions mean that risk plays an important part in the everyday lives of people with dementia, family carers, and practitioners yet there is little research evidence on how all these groups negotiate decisions about risk.  This presentation discusses the scoping review and consultation the presenters undertook in preparing a guidance document on risk for the Department of Health in the context of dominant ideas about risk and the rights of people to take decisions others regard as risky.  It highlights how little research evidence there is on how older people with dementia, family carers, and practitioners negotiate decisions about risk and how little the wider risk literature considers the impact of cognitive impairment when looking at how individuals make decisions about risk.  This discussion is set within the current policy context of risk empowerment and personalisation in health and social care policy in the UK.  The presentation concludes that debates in the wider risk literature about personal approaches to risk fail to acknowledge how personal approaches to risk are mediated by circumstances in which a person’s capacity to take risks are affected by illness or disability.  While biographical or narrative approaches to risk management take account of a person’s existing approaches to risk, we know very little about how the experiences of illness and disability might mediate approaches to risk.  Discussions about risk and dementia are broadly atheoretical and are largely located in concerns about litigation and complaint procedures.