R is for Risk.....

 

As Occupational Therapists we are often asked is it ‘safe’ for an older person to return home from hospital; what are the ‘risks’? Generally, this is referring to physical safety risks- will the person fall? Is there a steep stair-case with no rails? Might they set the kitchen on fire by forgetting a pan left on?

There is always a push to get patients home and free up beds, and of course hospital is not a good place for an older person to be. There is not the luxury of unlimited time to spend following up on someone who has recently got home from hospital. All these factors can mean that in planning for an older person’s return home, the emphasis on ‘safety’ means requiring them to not engage in certain occupations or use certain parts of their home, to become dependent instead of independent. There is a balance to be struck, and sometimes the person feels it is time to let go of previous occupations themselves, but there is a danger of discouraging valued occupations that contribute to an individual’s sense of self-efficacy and well-being.

In my J post, I looked at a paper by Jackson (in Zemke & Clark 1996- see books tab at top of page) called “Living a Meaningful Existence in Old Age’. One of the factors that she identified as contributing to a meaningful life was the chance to take ‘risks’. This did not mean doing dangerous or foolhardy things, but that people still wanted the opportunity to try new things, to learn new skills, to succeed or fail, to experience new things, to have challenge and excitement. It could also mean choosing to continue to engage in an activity that is personally meaningful. When an individual becomes disabled, they are often deprived of these opportunities.

As OTs our job is to enable individuals to participate in their chosen occupations as safely as possible, not to stop them! I’d be very interested to hear people’s thoughts on this.