Is this nursing home use for floor mats ethical?

In a recent “The Ethicist” column in the New York Times, Chuck Klosterman answered a question about mats. You may be wondering, what ethical quandary could something as innocuous as a standard, black mat pose? It turns out mats have a fascinating — if morally dubious — use in nursing homes for dementia patients.
From Ann.

A nursing home. From Ann.

The woman posing the question, an advocate for nursing-home residents, says that a new technique for controlling the wandering of dementia patients involves putting black floor mats in unsafe areas, including exits. Patients with Alzheimer’s and dementia view these mats as holes, and because of a fear of falling, they avoid these areas.
In 2011, the Times published a piece on Beatitudes, an assisted-living center in Phoenix, Arizona that installed sections of black carpet to keep dementia patients away from the fourth-floor unit’s elevators. “They’ll walk right along the edge but don’t want to step in the black,” Tena Alonzo, Beatitudes director of research, said. “We’ve actually had some so wary of it that when we have to get them on the elevator to take them somewhere, we put down a white towel or something to cover it up.”
nursing homes

Alzheimer’s patients will avoid black mats due to visual-spatial problems, so nursing homes have started to place them at areas they want these patients to avoid.

So what’s the problem? The letter writer questions the ethics of using fear and the symptoms of a disability to control patients’ behavior, even if it is for their own safety. However, the alternative method of controlling absent-minded wandering is to administer antispsychotic drugs and create lockdown units. It is this point that pushes Klosterman to support the mat method of control. He says:
"It presents the best compromise between dignity and utility for all involved parties (both patient and caregiver). If a dementia patient were in a position to describe how she would want to be treated, I’d assume she would want the maximum level of independence, the highest degree of protection and the greatest potential for mental clarity. This concept comes closest to achieving those goals."
What Klosterman doesn’t note is that these mats have the added, unintended benefit of preventing slips, trips, and falls for the nurses at work and any patients who happen across them. Mats: a method of ensuring both safety and dignity.
It’s safe to say we are in full support of this use for black floor mats, but what do you think? Let us know in the comments.

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