Living with Risk: Decision Support Approach
Overview
As a clinician, you may have struggled with decision making when you have concerns about a person’s safety. The Living with Risk: Decision Support Approach (LWR:DSA) is a comprehensive and systematic 4-step process to help assess and manage the risks to which an older adult may be exposed.
More specifically, the LWR:DSA:
About the approach
- Helps collect, organize, and evaluate information that is typically already gathered in situations that raise concerns about the safety of older adults;
- Ensures a wide variety of risk categories (both psychological and physical) are considered;
- Includes input from the older adult and their caregivers.
Using the LwR:DSA in practice
- Is flexible: It can be used as an individual or to structure team conversations;
- Has many benefits:
- Improves clinical reasoning and decision making by supporting a balanced problem-solving process that prevents over- and under-estimation of an older adult’s risk for harm;
- Improves communication between and among clinicians, older adults, and their caregivers by structuring and focusing potentially difficult conversations;
- Encourages a collaborative team approach within and between teams and organizations;
- Engages the older adult in problem solving to promote their safety and quality of life.
How to use
- Review the training e-module to learn about the 4-steps of the LwR:DSA;
- Videos available for additional information and clinical examples;
- Worksheets are optional but helpful to operationalize the approach.
How to cite this work
- All information on this web site is the intellectual property of the Living with Risk: Decision Support Research Group. Please contact us (under the "Contact" tab) if you would like to use and/or adapt any of this information.
- To cite information from these web pages, please indicate what you are referencing followed by: "The Living with Risk: Decision Support Approach (version January 2024). The Living with Risk: Decision Support Research Team. https://lwrdsa-vivreaveclesrisques.recherche.usherbrooke.ca"
Development
This approach was developed thanks to the following funding:
- Canadian Frailty Network Funding: An innovative decision tool to optimize hospital discharge in frail older patients living with risk (2019 – 2021; $70,000)
- Canadian Institutes of Health Research – Catalyst Grant: Quadruple Aim and Equity: Living with Risk: Decision Support Approach: a mixed method study to understand the facilitators and barriers to implementing a collaborative approach to risk assessment in both the hospital and community health settings (2022 – 2023; $99,851)
- Canadian Institutes of Health Research – Planning and Dissemination Grant: Developing training e-modules to support the uptake of a clinical decision support approach by health care professionals to broaden their approach to risk assessment and management (2023 – 2024; $10,000)
LWR:DSA also received in-kind support from the Regional Geriatric Program of Eastern Ontario and the Research Centre on Aging, CIUSSS de l’Estrie-CHUS.
The LWR:DSA Research Group
Principal Investigators
Véronique Provencher, OT, PhD. Université de Sherbrooke
Heather MacLeod OT Reg. Ont. DSc. (candidate) Queen’s University
Co-investigators
Dorothy Kessler, OT Reg. (Ont.), PhD, Queen’s University
Nathalie Veillette, OT, PhD, Université de Montréal
Nathalie Delli-Colli, SW, PhD, Université de Sherbrooke
Dominique Giroux, OT, PhD, Université Laval
Mary Egan, OT Reg. (Ont), PhD, University of Ottawa
Marie-Jeanne Kergoat, MD, FCFP, FRCPC, Université de Montréal
Krystina Lewis, RN, PhD, University of Ottawa
Jennifer Klein, OT, Glenrose Rehabilitation Hospital
Shaen Gingrich, PT, Geriatric Knowledge Translator, North East Specialized Geriatric Centre
Collaborators
Chantal Foidart, OT, Regional Geriatric Program of Eastern Ontario
Christine Allard, Manager, CIUSSS de la Capitale nationale
Sarah Boudreault, PT, CIUSSS de la Capitale nationale
Monia D’Amours, M.Sc., Research Centre on Aging, CIUSSS de l’Estrie-CHUS
Frédérick Roy, OT, CIUSSS de l’Estrie-CHUS
Natasa Obradovic, OT, PhD (candidate), Université de Sherbrooke
Ariane Grenier, OT, CIUSSS de l’Estrie-CHUS
Michelle Roy, OT, Glenrose Rehabilisation Hospital
