The dignity of risk a fine balance in aged care

Data detailing an increase in reported deaths caused by falls in residential aged care needs to be understood in the context of the dignity of risk, says leading not for profit aged care provider Benetas.


Benetas CEO Sandra Hills said that while the Premature deaths of nursing home residents: an epidemiological analysis[1] report gives an important insight into trends in residential aged care, consideration needs to be given to a person’s right to self-determination.


While we need to ensure our residential aged care environments are as safe as possible for residents, we need to consider how a black and white focus on falls prevention might compromise an older person’s quality of life,” said Ms Hills.


We often work with residents, their families and their medical and allied health teams to identify how we can best support them to have a happy life; for some this might mean walking unassisted or not wearing devices intended to prevent harm.


We need to work out how we can honour the older person’s right to choose, while maintaining their safety as best as possible. Managing the risk of choice, particularly in the current landscape of consumer directed care, is a very complex issue for providers.”


Ms Hills said that Benetas has developed a range of research and quality initiatives to address the risk of premature death in residential aged care.


In 2015, Benetas partnered with the National Ageing Research Institute (NARI) to better understand common themes around falls and what could be done to mitigate the risk.


We know that it only takes a relatively low impact fall for an older person’s health to be compromised and for this reason we want the likelihood of a fall to be reduced as much as practicable,” said Ms Hills.


Our work with NARI has helped us develop a comprehensive falls prevention pathway for our clinical teams to follow,” said Ms Hills.



This supports staff to recognise the potential for a fall and to identify individualised strategies, in addition to the standard assessment cycle, for each resident to ensure the risk is minimised.”


The organisation’s focus on quality has also meant that robust reporting mechanisms appropriately capture trends.


Our clinical incident data helps us to capture and monitor trends to ensure we’re delivering the most response care possible to our residents,” said Ms Hills.


We have had an ongoing focus on falls prevention for some time and we still want to improve in this area.


We want to ensure residents are able to live their best life at Benetas, whatever this might look like for them.”


See Progfessor Ibrahim's article "Many older people in care die prematurely, and not from natural causes." and

and Sarah Colyer's article "Aged care falls deaths: a question of balance" in MJA InSight.


[1] Ibrahim et al, Medical Journal Australia 206 (10) Online first 29/05/17


5 June 2017.