Purpose:  This study sought to enhance understanding of ethical concerns experienced in the care of persons with Alzheimer's disease. 

Problem:  Unexamined assumptions related to quality of life of persons living with Alzheimer's disease may suggest a poor quality of life. With good intentions, but limited insight, healthcare professionals and family members may fail to explore collaborative options effective in preserving a dwelling place for those with Alzheimer's. Theoretical framework:  Traditionally, quality of life is conceptualized within the biomedical healthcare model, which values cognitive ability as a critical element for quality of life.  Interpretive phenomenology was used in this study to provide a broader interpretation of health and illness and give voice to ethical concerns of persons living with Alzheimer's, enhancing understanding of sheltering vulnerable individuals.

  Methods: This phenomenological study used a Heideggerian hermeneutical approach to gather data through snowball sampling and unstructured interviews with 12 family caregivers and 4 persons with Alzheimer's disease.   Participants responded to the prompt: "Can you tell me about a specific incident that stands out in your mind that describes an ethical concern you have encountered in living with Alzheimer's?"  Interviews were recorded, transcribed verbatim, and analyzed within an interpretive phenomenological framework.

Findings and Implications:  "Sheltering the Vulnerable" emerged as a prominent theme in interviews, as participants described ethical concerns encountered in attempting to preserve dwelling places for persons with Alzheimer's.  Extension of traditional assumptions of  “quality of life” in dementia to incorporate “quality of interconnected lives” suggests that collaborative caregiving options, including long term care facilities, could provide needed dwelling spaces to shelter the vulnerable with Alzheimer's.