Presentation from launch event for Making the Case for the Social Sciences. No 11 Dementia at the House of Commons on 15 March 2016

1. ‘Nothing ventured, nothing gained’:
risk management for people with
dementia
MAKING THE CASE FOR THE SOCIAL SCIENCES 11: DEMENTIA
JO MORIARTY & JILL MANTHORPE

2. Context
 Asked by Department of Health to prepare a
practice guide that combined:
 Research evidence
 ‘Practice wisdom’ (including views of people with dementia
and family carers
 Fits into wider policy aim of evidence informed policy and
practice
 Document to be relevant across health and social care
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3. Most often presented in terms of ‘risk
of’ developing dementia
• ‘Link between
heavy smoking and
Alzheimer’s
suggested’
Cigarettes
• ‘Heavy drinking
may be to blame
for one in four
cases of dementia’
Alcohol
• ‘Obesity may be
linked to dementia’
Food intake
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4. Realities of everyday life
 Impact of Mental Capacity Act 2005
 Focus on ‘big’ decisions
 Moves to residential care
 Decisions about end of life care and advance care plans
 What about daily life?
 Giving up driving
 Cooking a meal or going out on one’s own
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5. Iterative process
 Contrasts traditional literature reviews
 Way of making content clear and relevant
 Recognises multiple expertise
 Help from Simon Ricketts
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6. 6Risk ‘heat map’
Maximise safety
enhancement and risk
management - protect the
individual and manage the
activity
Carefully balance safety
enhancement and activity
management to protect the
person
Minimal safety
enhancement necessary -
carry out with normal levels
of safety enhancement
Substitute - can the same
personal benefit be
delivered in a different way
- seek different activities?
Carefully balance safety
enhancement and activity
management to protect the
person
Minimal safety
enhancement necessary -
carry out with normal levels
of safety enhancement
Find alternatives - level of
risk is not related to the
benefit/value to the person
- find alternatives
Challenge real value of the
activity to the individual -
seek alternatives that are
more attractive and lower
risk
Undertake the activity or
seek alternatives that may
provide a better
relationship with their
needs
High
Low
High Medium Low
Contribution to
quality of life

7. Taking it forward
 Links with Making Research
Count and other training
 Adapted for staff working with
people with a learning
disability
 Advances in dementia care
 Coping styles, life history
suggest dementia is often
about a process of adaptation
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8. Disclaimer
The Social Care Workforce Research Unit
receives funding from the Department of Health
Policy Research Programme. The views
expressed here are those of the authors and not
the Department of Health
Thanks to Claire Goodchild who was responsible for
developing and leading on this work
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