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Overview of literature about enabling risk for people with cognitive disabilities in context of disability support services

Bigby, C.,, Douglas, J.,, Hamilton, L.,



This overview is based on a review of the peer reviewed and grey literature on risk and the practice of front line staff in supporting service users with cognitive disability. Our aim was to explore the questions: 1) What are front line staff experiences of enabling risk? 2) What are the barriers and facilitators that confront front line staff and others involved in disability support services in enabling risk for people with cognitive disabilities in particular people with intellectual disability or acquired brain injury? 3) What are the characteristics of models for risk enablement with people with cognitive disabilities? Much of the literature has a broad focus on community care services generally, concerned with generic groupings of service users but also specific groups such as those with dementia or poor mental health. Rather less is primarily concerned with support in the context of disability services and people with intellectual disabilities, and very little in respect of people with acquired brain injury. Our initial searches of three data bases for peer reviewed literature identified over 1001 items, many of which concerned broad policy, sociological or psychological aspect of risk. Some of these were already familiar to us, and provided the background for the review. These items were reviewed and by excluding items that were not directly pertinent to our questions, we retained 37 peer reviewed papers that were analysed in some detail. An internet search using Google identified 48 reports, policy or guidance documents from the grey literature including various training programs and models for risk enablement or management. This summary draws out the main themes in the peer reviewed literature on supporting risk and summarises several of the models identified for guiding supported decision making that incorporate risk enablement. The vast majority of the literature is situated in the UK context, with several from the Netherlands. The research reported is predominantly exploratory, qualitative and small scale.

Publication information

Location : Australasia

Domain/s: Health and wellbeing, Safety and security

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