A new case study published in the journal GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry raises disturbing new questions about determining the mental capacity of dementia patients. A 77-year-old woman with schizoaffective disorder and mild cognitive impairment, who had been homeless for much of her life, had been placed against her wishes in a locked dementia-specific hostel following a psychiatric admission for delirium. This had occurred without a formal coercive accommodation guardianship order, but with family consent. The patient was distressed by the placement, frequently expressing the wish to leave and attempting to escape. The mental health team assessed her capacity to decide where she should live. Ethical and legal issues raised by the case are presented with relevance to the burgeoning global advocacy for the autonomous rights of people with mental illness and cognitive aging shared across jurisdictions and common to many human rights frameworks.