Clinicians working with "at risk" older adults are often faced with the difficult decison to override a client's civil rights and force institutionalization. This decision, if made without the support and insight of other professionals, can create a variety of value conflicts within the clinician. This article presents a multidisciplinary decision-making model which encourages the clarification of values, professional ethics, and sharing of perceptions among professional disciplines before institutionalizing an unwilling "at risk" older client. The model is a first step toward clarifying value and ethical conflicts inherent in forcing services on unwilling clients. A review of social work and mental health literature indicates that little attention has been given to determining when an older adult should be the involuntary recipient of forced services.
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Hayes et al. (1986) studied this question.