Managing risk for people with dementia
We all take risks, we do it all the time. We cross the road without looking carefully, eat too much, exercise too little, drink too much alcohol or smoke to name just a few of the things that all of us do. And sometimes this has serious consequences, with the number of road traffic accidents there are a year, but there are far fewer accidents, than the numbers of people carelessly crossing the road each day.
People with dementia are still people, I have red hair (sometimes it is even referred to as being ginger!), but I’m not just known as that, I’m also a solicitor, resident of Plymouth and parent. There are lots of different facets to me, but when dealing with a person with dementia, why is that the key facet that is seen? They are more than that, much more. So if I can take a risk, why can’t someone with a dementia?
From the human rights aspect, they can, they are still human and human rights are universal! The overriding human right it the right to life, so as long as they are not seriously risking their life, everyone, including people with dementia should be allowed to make unwise choices. We are all allowed a private and family life, freedom of religion, as well as freedom of assembly and association and freedom from discrimination. We should all be allowed to exercise all of our human rights and it is only at the point that we risk our life, should our ability to exercise our human rights be curtailed and they should only be curtailed to the extent needed to protect our life.
In the Mental Capacity Act 2005, there is legislation regarding ensuring whatever decision is made on that person’s behalf, it is the less restrictive of their rights and freedoms. The key word here is less, it is not least, to do the least restrictive would be to do nothing, but that might mean that it is too risky and becomes a risk to their life. How many people with dementia say that they want to live at home with no help? They might want to, but would be dead in a few days if they did, as they have no ability to care for themselves. So the less restrictive might be to put in a daily carer, possibly even multiple times per day.
People with dementia are still people and like the rest of us, are completely unique, with their own views about themselves and the world around them. They might be very risk averse or happy to take risks, even big risks. All their characteristics needs to be taken into account when making a decision about someone with dementia, including what they say now, not just what they would have said when they were well.
The decision should be the less restrictive, let the person with dementia feel like they are still a person and not just a medical diagnosis and let them take a certain amount of risk as too restrictive a regime might be just as bad and dangerous for health as a too unrestrictive one. Balancing risk is about seeing the person first, as a real person and not just their dementia.
And to all carers out there, from time to time, you may get it wrong, but mostly you get it right and just by caring, you get it right. Keep up the good work.
If anyone needs advice in caring for a loved one, let me know, I understand.