Appendix IV, Risk Factors

Revision 19-0; Effective July 7, 2019

Identifying and managing risks are part of providing services and supports to people with intellectual and developmental disabilities. Depending on their individual circumstances, people who receive institutional and community services can be at risk of adverse outcomes. Identifying risks is an important part of mitigating future risks and adverse outcomes to the individual.

Identifying and Planning to Mitigate Risk at the Individual Level

Effective risk management begins with assessment and service planning centered around the individual’s needs and preferences. Potential risks are identified and documented, and individualized mitigation strategies are mapped out. Ongoing documentation of services targeted to address risk and negotiations around risk provide evidence of risk management.

Risk Management Begins with the Individual Assessment Process

Just as service planning begins with a needs assessment, risk management should begin with an effort to identify potential and perceived risks to the individual. In many cases, these risks are directly linked to the disability-specific needs identified during the assessment process. However, the presence and projected consequences of such risks may not always be documented in an individual’s record. Risk identification is more than a conversation between an individual, their family members, service providers, case managers and others. It also involves a comprehensive documentation of that conversation. Such documentation provides the context and rationale for elements in the service plan and provides evidence that a risk management process is in place.

Behavioral Risks

Some people with disabilities may place themselves and others at greater risk through their behavior. Behavioral risks include:

• poor decision-making about safety and health issues, as a result of a brain injury or cognitive limitation;
• violent or criminal behavior;
• substance abuse; and
• suicide.

Risks to Personal Safety

Many people who are elderly or who have severe disabilities are vulnerable to abuse and exploitation. They are often dependent on others for assistance with everyday activities, such as eating or bathing, as well as with participation in the community. Thus, they face the additional risks of neglect, abuse and financial exploitation. In addition, personal safety, including safe evacuation, can be compromised by mobility and cognitive impairments. Other personal safety risks can include unsanitary or unsafe housing and social isolation.

Additional information is available here (PDF).

For information about medical and health related risks, see the Common Risk Factors and Basic Clinical Guidelines to Gauge Level of Risk (PDF) chart.