As the prevalence of dysphagia in people living in residential care increases, so too does the challenge for aged care providers to balance safety and people’s right to eat what they want.

An analysis published by law firm O’Laughlins has identified that in most coronial inquests where residents have died from dysphagia issues have occurred when providers have not had the right risk management processes in place.

“With the expansion of home care services, those with frailties which previously necessitated residential care will be staying at home longer,” the briefing authors, Peter Myhill and Alice Woods, said.

“With 45 per cent of those diagnosed with dementia also impacted by dysphagia, it is reasonable to expect the prevalence of this condition in residential care will continue to rise.”

“The balancing act will continue – but on a higher tightrope because increasing staffing levels (without the benefit of increased funding) to accommodate the greater and more prevalent risks is unlikely to be affordable nor therefore, available.”

“Plainly the aim continues to strike a balance between resident choice and risk. It is necessary to note however that the cornerstone of risk assessment from a legal perspective is duty of care – which is dependent on what is reasonable in all the circumstances, including the availability of resources.

“The primary focus must be the duty of care that is owed to the resident and addressing the resident’s requests in that context.

“That said, the focus on duty of care also means a focus on putting in place and consistently following appropriate risk management procedures.

“We can see from the various Coroner’s investigations summarised in this article that it is often the failure of risk management processes, rather than the risk of the behaviour itself which creates the issues.”

“With increasing frailty amongst those in residential care, particularly in areas of cognition, the importance of risk management processes has never been higher.”

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