Charlotte L. Clarke is Professor of Nursing Practice Development Research and Associate Dean at Northumbria University in the UK.

Here, Charlotte answers some questions about her new resource, Risk Assessment and Management for Living Well with Dementia, co-written with Heather Wilkinson, John Keady and Catherine E. Gibb.

How did you become interested in issues around dementia?

I have always enjoyed being with older people and so when I started to work as a nurse I worked with older people and increasingly with people with dementia and their families. This became the focus of my PhD and I have subsequently sought to develop health and social care practice through research and through education and publishing in a way that helps us all to ‘hear’ the views of people living with dementia and provide care that respects their views.

Why was it important to write this book, and why now?

Together with colleagues who have co-authored the book, I have led several research projects that have focused on risk management in dementia care, and the book is a summation of that work in a format that is designed for practitioners. People with dementia continue to have decisions about them made by other people who bring to that decision their own views of safety and risk – these can be very profound decisions such as where someone will live in the future. It continues to be essential to develop services that respect the views of people living with dementia so that the care they receive is of high quality (and this is not necessarily care that is ‘risk free’).

What does it mean to live well with dementia?

Living a life that you value and in which you feel valued.

What are some common misconceptions about managing risk in dementia care?

One of the most common is that a risk is always harmful – yet in other circumstances people may be encouraged to ‘take a risk’ in order to achieve something. Another misconception is that it is possible to eliminate risk – it isn’t! very often what we do is minimize one kind of potential harm but actually may create another (an example is in limiting the movements of people with dementia to reduce the threat of falling say but in so doing we may create a potential harm to their sense of wellbeing and independence). In the book we call these ‘silent harms’ because they are very damaging to the person but are less visible to families and practitioners who may well focus on keeping someone physically safe.

In the book, we hope that we provide information and some tools to help practitioners manage risk with confidence so that they are less likely to be risk-adverse. We also hope that they will do so in a way that includes the person living with dementia and respects the way they would like to lead their lives. The book includes lots of examples of people and families living with dementia, and views of practitioners. These are drawn from several research studies that we can completed. There are also lots of short sections titled ‘Think about…’ which are designed to encourage the reader to just pause and reflect on their own views. Risk theory is very complex and we hope that the book helps the reader to understand some of the key issues and helps them to think about how they can use these ideas to enhance their own care.

We hope that the reader will take on a new way of thinking about risk management so that next time they are working with someone living with dementia they can think about several different ways of supporting the family.

Copyright © Jessica Kingsley Publishers 2011.

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