Top Tips for Positive Risk-Taking in Dementia Care

Why This Matters

Every meaningful life includes uncertainty. Walking outside, preparing food, travelling, forming relationships or choosing how to spend the day can involve risk. If support focuses only on preventing harm, people living with dementia may lose independence, confidence, purpose and the right to make ordinary decisions.

Introduction

Positive risk-taking does not mean ignoring danger or leaving someone without support. It means balancing possible harm with the benefits of the activity, the person’s wishes, their strengths and the risks created by stopping them. The aim is not risk-free living. It is thoughtful, proportionate support that enables life while reducing avoidable harm.

Real-Life Example

A man wanted to continue walking to a nearby café. The first response was that he should stop because he had once taken a wrong turn. Instead, the team spoke with him and his family, practised the route, agreed a quieter time, made sure he carried contact details and arranged for café staff to know what support might help. The plan could not remove every risk, but it preserved a valued routine with sensible safeguards.

Mike’s Reflection

I sometimes hear “We cannot let them” before anyone has fully explored the person’s view or the benefits involved. Safety matters, but restriction has consequences too. A better starting question is often, “What is important here, what could go wrong, and how might we support this more safely?” That changes risk from a reason to stop into a problem to understand together.

This Week’s Top Tips

Begin with the person and the benefit

• Find out what the person wants to do and why it matters to them.
• Identify the benefits, such as independence, identity, connection, movement, confidence or enjoyment.
• Consider the effects of preventing the activity, including frustration, loss of skill, isolation or distress.

Understand the actual risk

• Describe the specific concern rather than using vague statements such as “it is unsafe”.
• Consider when, where and how the risk occurs, as well as the person’s strengths and previous experience.
• Involve the person and relevant others in discussing options, while following capacity, safeguarding and organisational procedures.

Enable with proportionate support

• Reduce avoidable hazards through prompts, equipment, practice, timing, accompaniment or environmental changes.
• Agree what support is needed, who will provide it and what signs would trigger a review.
• Record the balanced decision and revisit it when circumstances, abilities or wishes change.

A Gentle Reminder

A positive approach to risk is not permission to be careless. It is a disciplined way of considering rights, benefits, hazards and support together.

October Dementia Care Challenge

Notice one automatic “no” this week. Pause and ask: “What benefit matters to the person, what is the specific risk, and what could make this safer?”

Over to You

Where could a more balanced conversation help someone keep an important part of their life?

Remember: Small Moments can make a Big Difference.

Evidence and development notes

• Department of Health guidance describes best practice in assessing, managing and enabling risk for people living with dementia.
• Positive risk-taking guidance stresses balancing benefits against harms and recognises that apparently risk-free options carry risks of their own.
• NICE dementia guidance emphasises involving people in decisions and promoting independence and wellbeing.