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Court: No involuntary commitment for Alzheimer’s

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9:15 a.m. CDT, April 29, 2011

A state appeals court ruled this week that Alzheimer’s patients can’t be committed against their will, saying involuntary commitment was only permissible for people with mental illnesses that can be treated.

In reversing a lower court’s ruling, the District II Court of Appeals in Waukesha said Alzheimer’s disease doesn’t fit in that category.

“There are no techniques that can be employed to bring about rehabilitation from Alzheimer’s; an individual with Alzheimer’s disease cannot be rehabilitated,” the court said.

The ruling, which could transform the way nursing homes and law enforcement deal with older adults who have dementia, was hailed by advocates for seniors.

Kristin Kerschensteiner, a managing attorney with Disability Rights Wisconsin, filed an amicus brief in the case saying Wisconsin’s involuntary-commitment law, known as Chapter 51, could be abused.

“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,” Kerschensteiner told the Milwaukee Journal Sentinel. “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.”

The ruling Wednesday stemmed from a case involving an 85-year-old woman with Alzheimer’s, identified as Helen E.F. of Fond du Lac.

She was detained last year under Chapter 51. The law allows officials to detain someone suffering from a mental illness, drug dependency or developmental disability on an emergency basis if they present a risk of harm to themselves or others.

The appeals court ruled that Chapter 51 doesn’t cover Alzheimer’s disease because the condition can’t be treated.

“Even if we were to assume, which we do not, that Alzheimer’s disease could reasonably be classified under Chapter 51′s definition of `mental illness,’ commitment of an individual with Alzheimer’s disease falls outside the scope of Chapter 51′s limited definition of `treatment.”‘

Tom Hlavacek, the executive director of the Alzheimer’s Association of Southeastern Wisconsin, said the ruling would have “big implications” in the state. He said the decision would make it harder for nursing homes to discharge people, and also make it harder for police to detain someone with Alzheimer’s who might exhibit aggressive and agitating behaviors.

“It’s going to require a lot of scrutiny of how we’re handling those cases right now and going into the future,” he said.

There are about 110,000 people with Alzheimer’s disease in Wisconsin.

The Wisconsin Health Care Association is a nonprofit group that represents more than 190 nursing facilities in the state. Brian Purtell, its director of legal services, said he thought the ruling was significant but added that Chapter 51 was used only infrequently to detain Alzheimer’s patients.

“I think the volume of use of Chapter 51 to address people with Alzheimer’s is not as common as it would appear in that (task-force) report,” he said. “I think the practical issue is that maybe more counties will now see this decision and say we will not be able to address a behavioral situation in an emergency situation under 51 if the individual’s sole diagnosis is Alzheimer’s.”

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The Journal Sentinel’s report can be found at: http://bit.ly/k26T6F

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Information from: Milwaukee Journal Sentinel, http://www.jsonline.com

AP-WF-04-29-11 1710GMT

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