The Importance of Balancing Risk and Freedom of Choice in Care Settings
By Jackie Cooper, Occupational Therapist at The Good Care Group
With Good Care Month just behind us, at The Good Care Group we want to draw attention to the importance of balancing risk and freedom of choice in care settings.
In our experience, the level of freedom someone enjoys has a direct impact on their overall happiness.
When older people who require care and support lack freedom, it can lead to feelings of frustration, helplessness, and boredom, but by giving them choices and opportunities to pursue their interests, and exercise their independence, including allowing them to pick their own activities and choose their own meals, care providers can enhance their wellbeing and quality of life.
An assessment of an individual’s mental capacity under the Mental Capacity Act is important to ensure that every individual has access to care that enables them to maintain a baseline of freedom and independence, ensuring patients can remain in their own home as long as possible. However, mental capacity is assessed on specific decisions and is not something that should be used as an overall assessment of an individual’s capacity.
In this article, I’ll explore how we achieve this at The Good Care Group, through taking an individualised, and bespoke approach to care.
The importance of independence
It’s vital to ensure people receiving care have a baseline of independence and it’s therefore important that care managers take the time to assess a client’s specific needs and to determine what they want and what their desires and wishes are.
If an individual has always gone to bed at six o’clock in the evening and has always got up at six o’clock in the morning, that is their choice and we make it our priority to work around them and their desires and needs.
With clients who have capacity, we talk a lot at The Good Care Group about positive risk taking and the ability to make “unwise choices” as part of the Mental Capacity Act. So, although we would prefer a client didn’t go out on their own at 10:00 at night for their walk because of the potential risks associated with getting lost and potential falls, from the client’s perspective they’ve been doing this for years and understand the risks.
We now have a system in place which we call positive risk taking, where we sit down with clients and go through our concerns and their understanding of the risks they’re taking as well as some of the consequences of them taking those risks. Some people will make risky choices but not really understand what the impacts are, so it’s crucial to evidence that the discussion has taken place.
A client’s spiritual needs also come into this discussion as it may be, for example, that they wish to take a walk on a Sunday morning by themselves, and we can therefore have conversations about the safest way this can happen.
Empowering care staff
Ensuring resources are put into training care staff to consider the balance between risk and freedom of choice, is vital.
At The Good Care Group, we prioritise working with clients and family members on individualised care plans and design these with clients’ wishes and needs in mind.
We are focusing heavily on enrichment at the moment, which involves not just focusing on providing physical care but providing and supporting them with activities that enrich and add to their lives.
For clients who are living with dementia, we are in the process of training our carers on Individual Cognitive Stimulation Therapy, where they will be able to deliver this in structured 20-minute sessions and involves taking part in a creative activity, or a hobby such as gardening or baking alongside quizzes and reminiscence activities. This enables carers and clients’ families to spend quality time with the client by providing stimulation and meaningful activity.
How technology can enable freedom in care
Technology in care settings can help monitor and mitigate risks without impinging on freedom.
For example, we have a system called the Client Community at The Good Care Group which allows family members to be involved in decision making and easily view daily care notes. This enables clients to spend more time, with both carers and family members, on more enriching activities as all parties will have instant visibility of any care incidences and whether this has been managed adequately.
Electronic Health Records are also of utmost importance in creating and maintaining personalised care plans that are easily accessible to all carers involved. With less time being spent on administration and checking using antiquated systems, the more time can be spent on focusing on an individual’s care needs.
To conclude, it’s vital that care providers work with both individuals and families to ensure care plans are empowering, making sure individuals feel free to choose how they live their lives. People are complex, and come in all shapes and sizes, and care providers should not take a one-size-fits-all approach. By taking the time to consider a person’s emotional, health and spiritual needs, all while balancing this with the risks involved in care, this will ensure individuals receive the care they need and deserve.
