Dignity of Risk

What is Dignity of Risk?

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Dignity of risk is the right to live life in a way someone chooses, even with risk. It recognizes that daily life is uncertain and that taking normal risks can lead to positive outcomes in quality of life, health and well-being.

Why is the Dignity of Risk approach to care important to older adults?

Most older adults (65+) want to keep their independence and make their own (or be involved in) choices instead of being “kept safe.” When living with frailty or dementia, older adults should be supported to live in ways that reflect what matters most to them as much as possible.

Barriers to Dignity of Risk

Our own worries can make us want to do things for older adults to help them avoid risks. Common barriers include:  

• Worry or fear that something bad will happen
• Ageism, or the belief that older adults cannot make their own choices
• Being overprotective, which can stop meaningful activities
• Focusing only on safety, such as preventing falls, instead of balancing risk with quality of life 

How we can support older adults living with frailty? 

We can help older adults by:

• Supporting reasonable risks that have benefits
• Respecting their choices, values and independence
• Learning what matters most to them
• Reducing risks, when possible, without removing meaningful activities
• Supporting their dignity for as long as possible 

What types of risks are common?

Older adults living with frailty or dementia may face risks such as:

• Falling
• Difficulty using appliances
• Not taking medications properly
• Becoming disoriented on outings
• Challenges with personal care 

The level of risk depends on the person’s health, frailty level, living or social situation, supports available and awareness of the risk.

Balancing risk and independence 

How risks are managed often depends on the comfort, experience and skills of caregivers and healthcare providers. When safety is a concern, the goal should be to adapt activities, not remove them. Discuss with older adults how activities can be modified so there is less risk.

Examples include:

• Living at home: Work with caregivers and healthcare teams to identify and lower risks.
• Walking or going outside: Wear bright clothing, use a GPS device or go with a support person.
• Cooking: Install stove sensors or have someone check in after cooking.
• Moving around the home: Use a cane or walker, add grab bars, improve lighting, keep pathways clear of clutter or have someone walk with them. Strength and balance exercises can also help maintain independence. 

“There is a life for us, if we risk it.”

A person living with dementia, in “Nothing Ventured Nothing Gained: Risk Guidance for People with Dementia” Department of Health and Social Care. (2010). Nothing ventured, nothing gained: risk guidance for people with dementia. United Kingdom.