The topic I am exploring this month is positive risk taking within a client centred approach and if this is something we actually follow through with when in practice.
In order for our clients to develop their skills, positive risk taking is an essential part of our work. It is very evident in most of our theory work (for example university work or case studies) but do we as health professionals actually take these risks to enable our clients to develop a higher level of independence?
This aspect of care is relevant to all settings however due to the increasing ageing population within the UK I am going to focus on the support given within care of the elderly.
This older population have caused a higher demand for long term care settings within the UK and so the government have been working toward an increase of opportunities to enable people to be care for within their own homes – to do his however it is essential that our older population maintain a level of independence for as long as possible.
Scotland are working toward making their older population as independent as possible with the introduction of the reablement scheme. With this scheme they hope to take positive risks with support in order to develop individuals skills rather than just caring “for” them. The hope if that they will increase independence for this more dependant population and relieve some of the pressure and demand on care facilities on a long term basis. (Nothing Ventured Northing Gained, 2010. Better outcomes for older people, 2005).
Healthcare settings are all extremely busy places with both time and staff constraints on many health professionals. With these constraints in the workplace it can be seen as much easier, faster, and safer to complete activities FOR individuals rather than supporting them to develop the required skills to increase independence. An example of this which I have saw in many settings is dressing practice with the elderly. Due to time contracts in the morning of a busy nursing/residential home it is tempting to do activities for the residents like putting on items of clothing without even assessing wither of not that resident is able to complete that tasks themselves or not.
It is here we have to ask ourselves as allied health professionals if we are taking enough positive risks in order to develop and or maintain that individuals skills. In order to provide a client centred approach we have to weight up the risks with the benefits of each activity. If the benefits for that particular clients outweigh the risks then we should be supporting that client to complete the activities – along conducting risk assessments and minimising any potential risks to client.
By taking these risks we are giving our clients the opportunities they need to develop and maintain skills – if we take these risks away by completing activities for our individuals, how will they get opportunities to maintain their skills?
If we look as Maslows hierarchy of needs, we aim to to support our clients to reach self actualisation. Maslows first level is biological and physiological needs which include our everyday activities that we do to survive. Maslow’s hierarchy explains that if an individual is not supported to complete this level they connect move up to reach self actualisation. So although a task may seems small it is important as health professionals we assess the risks to enable our clients to complete activities as independently as possible.
As allied health professionals we are focused on client centred approaches and so not only do we have to take positive risks to give clients opportunities to complete tasks, but we also have to ensure they are they meaningful activities to that particular individual. If we look at the Model of Human Occupation (MOHO) this reinforces the importance of motivation, roles, routines and environment to develop an individuals performance capacity.
From this we need to access the whole person for example if we have a client who suffers from fatigue we can encourage a client to dress themselves which will help them reach Maslows first level, however if they are not motivated to complete this themselves but would rather be supported with a social task then we can give them more support to dress, leaving energy to complete a social activity that is meaningful to them.
In order to give our clients the support they need we need to look at each person individually to access what is meaningful and motivates them. From this we can take positive risks in order to enable that individual to be as independent as possible with that particular activitie, supporting them to reach performance capacity along with Self actualisation.
As the old saying goes “Give a man a fish, feed him for a day. Teach a man to fish and feed him for a lifetime”