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Allowing residents to make their own day-to-day decisions is essential to the assisted living philosophy. But what happens when a resident wants to pursue an activity that may be detrimental to their best interests? Increasingly, assisted living providers seek to resolve such dilemmas through the use of "negotiated" or shared risk agreements. To help providers understand and develop effective risk agreements, the Assisted Living Federation of America (ALFA) released a manual for providers called, "Negotiated Risk Agreements in Assisted Living Communities."

"Negotiated risk agreements are, at their best, a negotiating and problem-solving tool designed to bring residents and the community to a mutually agreeable level of ?choice? and ?risk,?" said Ken Burgess, ALFA?s General Counsel and author of the risk manual. "Increasingly, assisted living providers are being asked to push the envelope by allowing clients to take risks in the spirit of promoting autonomy and independence. But negotiation of risk with a resident does not necessarily mean the elimination of risk for the provider. This manual should help them reach a middle ground."

The manual attempts to tackle some difficult issues surrounding negotiated risk agreements including the mental capacity needed by a resident to enter into a negotiated risk agreement, waivers of liability, and other issues where there is little or no binding legal precedent.