The increasing incidence of dementia, and profile it is gaining in the public imagination, means that this is a condition that none of us can ignore. What role might a strengths approach have to play in the way we view people living with dementia? It is all too easy to see the negatives and deficits around someone living with dementia, and to remain oblivious to their capabilities and potential, as well as the supportive resources they have around them. Just because you have a particular label doesn’t mean you have lost all capacity to dream and desire a reasonable quality of life for yourself, as determined by you, not imposed on you by others. However, the so-called ‘community’ can become a progressively challenging place as cognitive capabilities decline.
‘Positive risk-taking’ is a concept well established by the Practice Based Evidence consultancy, and it applies equally to the risks a person living with dementia may wish to take, and to all of us who live in, work in and develop communities. The Joseph Rowntree Foundation commissioned a piece of work from a collaboration of Practice Based Evidence and the Mental Health Foundation to investigate how the concept of positive risk-taking may apply to the government initiative of developing dementia-friendly communities. The think piece is explored in the published ‘Viewpoint’ at the following link:
“Those with dementia are still people and they still have stories and they still have character and they’re all individuals and they’re all unique. And they just need to be interacted with on a human level.” [Carey Mulligan].
Check out ‘Still Alice’ as a great portrayal of the tragic descent into dementia, and the impact on a wider family as well as the person living with the condition.
What role does leadership play in good practice regarding how we work with risk? Leadership is often lacking, and management is all too often to the fore where considerations of risk are concerned in health and social care agencies. In this scenario fear and back-covering hold the attention, while good practice is presented as an unconvincing façade. Managers strangely play down any questions about excessive bureaucracy while still demanding all the paperwork is completed as the primary target. If something goes wrong it is the paperwork that gets sole attention, and real practice considerations are relegated to a place somewhere to the right of obscurity.
‘Good paperwork is a sign of good practice’ becomes the convenient smokescreen. This would be true if there was less management and more supportive leadership, as the need for paperwork would be put into perspective: as the essential minimum to support good practice not to hinder it. Good tools are a range of checklists and formats that have been shaped by good practice, and thus they are able to guide and prompt firstly, and capture good practice as a secondary function.
The Risk Decision-Making publication is the update of 17 years of working with individual practitioners and teams across countless organisations, both from within the Sainsbury Centre for Mental Health initially and through the Practice Based Evidence consultancy since 2001. The tools and guidance are informed by what we know from the national and international research, but more significantly through the practice based evidence of hundreds of practitioners across all disciplines and service sectors. Most importantly, this publication refocuses the attention on risk as everyone’s business; so it is structured throughout to address issues from the perspective of individual’s, teams and the leadership & management of organisations. Whatever systems your leaders have bought or put into place there is still a role for guidance on best practice, so look no further.