"The reason we were so concerned about this issue is that we see unfortunately a lot of situations where nursing homes don't want this individual there anymore because they lash out; and the quickest, easiest way to remove that person was to use Chapter 51, whether appropriate or not. Fast and quick, call the cops, get them out. That isn't the appropriate response"...Alzheimer's Reading Room
In April 2010, Fond du lac County instituted Wis. Stat. chapter 51 involuntary commitment proceedings against an 85-year-old woman (Helen) suffering from Alzheimer’s disease. Helen lives in a nursing home, suffers from dementia, and has limited verbal communication.
In general, chapter 51 allows counties to petition for the involuntary commitment and treatment of mentally ill, drug dependent or developmentally disabled persons who evidence “a substantial probability of physical harm” to themselves or others.
When Helen’s behavior became disruptive and aggressive, staff transported her to a hospital. Shortly thereafter, the county instituted involuntary commitment proceedings, arguing that treatment would not cure Helen’s dementia, but would control her aggressive behavior. A psychiatrist testified that Helen’s agitation and aggressiveness could be treated with medications that have calming effects.
Ultimately, the circuit court ruled for the county, finding grounds for Helen’s involuntary commitment and medicinal treatment. Helen, whose appearance at all proceedings was waived because “she would not understand or comprehend or be able to participate meaningfully,” appealed through her court-appointed state public defender.
In Fond du lac County v. Helen E.F., 2010AP2061 (April 27, 2011), a Wisconsin appeals court reversed, holding that persons with “degenerative brain disorders” like Alzheimer’s cannot be committed involuntarily for rehabilitation and treatment under chapter 51.
Issue of great import
The appeals court cited a report entitled “Handcuffed: A Report of the Alzheimer’s Challenging Behaviors Task Force,” which indicates that 110,000 Wisconsin residents are living with Alzheimer’s disease.
Kristin Kerschensteiner, a managing attorney with Disability Rights Wisconsin, said the ruling could lead "to real change" in the way nursing homes and mental health facilities deal with those who have Alzheimer's disease.
"The reason we were so concerned about this issue is that we see unfortunately a lot of situations where nursing homes don't want this individual there anymore because they lash out," said Kerschensteiner, who filed an amicus brief in the case. "And the quickest, easiest way to remove that person was to use Chapter 51, whether appropriate or not. Fast and quick, call the cops, get them out. That isn't the appropriate response."
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Original content Bob DeMarco, the Alzheimer's Reading Room