Personal Care: The Safety in the Dignity of Risk

By: Kristen Williams

Let’s face it: needing care is hard. It involves a level of uncertainty that is on-par with hospital patients, where your basic needs hang in the balance, and whether or not you get dressed on time depends on staff availability.

While there are many things about receiving care that feel so beyond many clients’ control, one aspect we should always get to choose is our level of risk. More specifically, clients (and attendants) should be able to individually consent to risk as part of care, meaning that they acknowledge the risk associated with some care activities and willingly agree to take such a risk. In the healthcare world, this is known as “The Dignity of Risk”: “The concept of affording a person the right (or dignity) to take reasonable risks, and that the impeding of this right can suffocate personal growth, self-esteem and the overall quality of life.”

So where does the dignity of risk show up in care? Well, let’s say that you’re a client with an upcoming job interview and would like to dye your hair so you look your best and feel confident. Seems like a reasonable request, right? This is a situation-specific need whereby you provide the materials, and make yourself flexible around staff availability. Of course, boxed hair dye contains chemicals that can be strong and should be applied carefully. Dyeing your hair then, implies a certain level of risk (and trust) in the staff assisting with it.  

Unfortunately, in this scenario, many agency care providers can and do decline to assist with this type of activity, citing that the associated risk is too great. They would likely state that the chemicals are too dangerous for staff to work with and that, as such, it is outside the scope of their responsibilities.

To those who work in healthcare or don’t receive personal care, dignity of risk might seem antithetical to safety. Many of our current care systems, including assisted-living facilities and hospitals, err on the side of caution, by reducing client agency and tightening the parameters of standard care. With the example stated above, this would mean saying “no” to any assistance with hair dye in the assisted-living setting, even though this is not something said client can do independently. Declining to assist with such an activity not only means that none of the clients that live there can ever dye their hair, it also removes the ability of client or staff to consent to said risk.  

Removing the dignity of risk might seem like the safest move, but doing so ignores the nuances of care and those that participate in it. Ignoring care needs actually creates more risk in other areas, as staff will sometimes attempt to “bend the rules” or worse, clients will reach out to other, less-experienced people who do not know the basics of helping an individual with disabilities. In this way, refusing to allow clients to take reasonable risk simply pawns the risk off to another, less familiar area, whether it be within their staff or clients’ personal lives. 

Implementing policies which are grounded in, and not deterred by, clients’ and attendants’ rights to take reasonable risk allows for the safest, most interdependent form of care. Both client and attendant foster trust with each other and the agency through their ability to agree to a certain level of risk, and in turn, the care provided becomes transparent and mutually beneficial.

We’re live in Ottawa! Join our beta here if you’re in the city. For those outside of Ottawa, join the waiting list here so we know where to expand next!

Header image (wheelchair cyclist) via Unsplash | Ariel Pilotto

Kristen Williams is a counselor who specializes in trauma-informed support for individuals with disabilities. She is enrolling to do her Masters in psychotherapy this fall and enjoys listening to too many comedy podcast episodes in her free time.

You can contact her for support or information at kristen.williams10@gmail.com or reach out on Twitter, @kdub155.