Human Rights and Confinement of People Living with Dementia in Care Homes

This article responds to growing concerns in human rights practice and scholarship about confinement of people living with dementia in care homes. Moving beyond the existing focus in human rights scholarship on the role of restrictive practices in confinement, the article broadens and nuances our understanding of confinement by exploring the daily facilitators of confinement in the lives of people with dementia. The article draws on data from focus groups and interviews with people living with dementia, care partners, aged care workers and lawyers/advocates about Australian care homes. It argues that micro-level interrelated and compounding factors contribute to human rights abuses of people living with dementia related to limits on freedom of movement and community access of people living with dementia, at times irrespective of the use of restrictive practices. These factors include immobilisation and neglect of residents, limited and segregated recreational activities, concerns about duty of care and liability, apprehension of community exclusion, and pathologization and subversion of resistance. It is necessary to challenge the organisational, cultural, economic, and social dynamics that shape day-to-day, microlevel, routine and compounding factors that remove the agency of people living with dementia and in turn facilitate entrenched and systematic human rights breaches in care homes.