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The ethics of locked special care units for persons with Alzheimer's disease

Family Respite Center in Falls Church, Virginia; Akheimer's Association National Public Policy Committee

Mary Cipriano Silva, PhD, RN, FAAN

Center for Health Care Ethics, College of Nursing and Health Science, George Mason University, Fairfax, Virginia

Ten percent of nursing homes in the United States have special care units for persons with Alzheimer's disease. Over three-fourths of these units have locked doors or use other methods or devices aimed at controlling patients who wander from the unit. In a time when the literature isfilled with moral arguments about older adults' rights and respect for their autonomy, locked special care units seem to be a reversal of this trend. Using paternalism to justify locked units is discussed and is based on the theory that many Alzheimer patients have diminished capacity to choose right from wrong and therefore have limited autonomy. Nurses are obligated to safeguard their well-being and protect themfrom wandering into harm.

American Journal of Alzheimer's Disease and Other Dementias®, Vol. 8, No. 4, 12-15 (1993)
DOI: 10.1177/153331759300800403


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