## Facts

- Helen E.F., an 85-year-old nursing-home resident, had advanced Alzheimer’s disease described as incurable and degenerative.
- She exhibited agitated and aggressive behavior toward staff, including striking caregivers and refusing necessary care.
- After an escalation, the nursing home transported her to a hospital emergency room, where her aggressive behavior continued.
- A police officer placed her under emergency detention pursuant to Wis. Stat. § 51.15.
- Fond du Lac County petitioned for involuntary civil commitment under Wis. Stat. ch. 51 for up to six months in a locked psychiatric unit.
- Medical testimony indicated Alzheimer’s could not be cured or reversed; psychotropic medications might reduce agitation or aggression but would not change the underlying disease.

## Issues

1. Whether a person with advanced Alzheimer’s disease is a “proper subject for treatment” under Wis. Stat. § 51.20(1)(a) when proposed interventions may manage behavioral symptoms but cannot therapeutically treat the underlying degenerative condition.
2. Whether the statutory scheme directs that individuals with degenerative dementia and related safety concerns should proceed under Wis. Stat. ch. 55 (protective services/placement) rather than Wis. Stat. ch. 51 (treatment-oriented civil commitment), absent a distinct, treatable mental illness.

## Decision

- The Wisconsin Supreme Court affirmed the court of appeals and reversed the circuit court’s ch. 51 commitment order.
- The court held Helen was not a proper subject for treatment under ch. 51 on the record presented.
- The court concluded Helen’s circumstances fit ch. 55’s protective placement and services framework, which is tailored to degenerative brain disorders and includes additional procedural protections.

## Legal Principles

- Under Wis. Stat. § 51.20(1)(a), ch. 51 commitment requires that the person be a “proper subject for treatment,” meaning the proposed interventions must be therapeutically directed at a treatable mental illness rather than providing custodial confinement or environmental control.
- Symptom control measures that do not meaningfully address an underlying, untreatable degenerative dementia generally do not satisfy ch. 51’s treatment requirement.
- Wisconsin’s statutory structure distinguishes between treatment-oriented civil commitment for mental illness (ch. 51) and protective placement/services for degenerative brain disorders such as Alzheimer’s (ch. 55).
- Using ch. 51 to address dementia-related dangerousness risks bypassing ch. 55 procedures intended for long-term protective placements and related due-process protections.

## Conclusion

The court invalidated a chapter 51 commitment for an elderly person whose primary condition was advanced Alzheimer’s, concluding that the statutory “proper subject for treatment” requirement was not met where only behavioral symptom management was available and that protective placement under chapter 55 was the appropriate legal mechanism.


In re Mental Commitment of Helen E.F., 814 N.W.2d 179 (Wis. 2012)