Risk: ‘I know it when I see it’: how health and social practitioners defined and evaluated living at risk among community-dwelling older adults

Abstract

Older adults are increasingly choosing to stay and age in their home or other place where they normally live, even when a change in their health reduces their ability to live independently creating concerns about their safety. In this context, community practitioners need to be aware of risk assessment and management strategies as they support their clients’ choices when safety is a concern. This requires an understanding of living at risk and an ability to evaluate the client’s risk status. This article is based on a qualitative research study in which we interviewed 12 Canadian community practitioners in 2012 and explored how they defined, perceived, assessed and managed risk and how they balanced their client’s safety and autonomy. We used a grounded theory methodology to collect and analyse the data. We found that participants tended to define living at risk as a judgement about a client’s impairment within an environment that can cause an event that has an increased potential for a negative consequence. We also found practitioners evaluated the client’s risk by considering seven factors: the client’s capacity and their support, the occurrence, imminency and frequency of the event, the severity of the consequences, and the number of other events co-occurring. In this article, we show that practitioners are comprehensive in their evaluation of the client’s risk. Although practitioners saw risk and living at risk from a negative perspective, they were able to acknowledge that it could coexist along a continuum from safe to unsafe.

Keywords:

• balancing safety and autonomy
• community
• risk
• living at risk
• risk perception
• risk assessment
• risk evaluation
• older adults

Acknowledgements

This study was conducted as a part of the requirement for a Master’s of Science at Dalhousie University and received no financial support. This research project could not have happened without the belief in and commitment to the project from the participants and their managers. Despite very busy clinical schedules, the participants all took the time and effort to provide their reflections. I would like to thank my thesis advisors Robin Stadnyk and Breada Beagan for their help and guidance and the feedback of the anonymous peer reviewers.

Notes

1. All names are pseudonyms.