10-3-16 National:As a youngster Thomas T. was convinced his parents couldn’t be doing the things he was learning about in sex education class. Thomas at 59 is certain that his 81-year-old father couldn’t possibly be engaging in sex in his nursing home. Thomas needs to think again. Taboo in past years, the subject isn’t any longer.
Sex Happens in Nursing Homes: Get Over It
Sex happens. And in nursing homes. A lot. A recent study in the New England Journal of Medicine reveals that many senior citizens are engaging in intercourse, oral sex and masturbation. The figure for those 57-64 years-of-age is 73%; for the age group 65-74, the number is 53% and for those 75-85, its 26%. According to an article by Anthony Cirillo on the website www.verywell.com, a survey of 250 residents in nursing homes in Texas found that 8% had had intercourse during the month prior to taking the survey. What’s more another 17% wished they had!
Nursing Homes Need Policies that Cover Sexual Issues
The same site reports that the Hebrew Home in Riverdale New York suggests family members should be educated to advocate for the resident, insisting upon policies in the nursing home that enhance quality of life. These policies should include a potential sexual relationship.
Researcher Robin Stadnyk reported in the journal Topics in Geriatric Rehabilitation that marital intimacy does not end when one spouse enters a nursing home and the other stays home. Based upon the findings, nursing home facilities should adopt a policy that allows couples to do in residency what they would do at home. The facilities should assist couples to continue their physical relationship by providing quiet, private spaces where intimacy can take place and insist employees knock before entering.
Intimacy and Dementia: The Issue of Consent
The issue of whether those living in residential facilities due to Alzheimer’s or other dementia have the capacity to consent to sex is problematic. The residents’ rights must be balanced with the duty to protect against predatory behavior.
The issue of consent comes up even with married couples where one is in a nursing home due to dementia. Consider the case of an Iowa couple, Henry and Donna Rayhons. The nursing home contended that Mrs. Rayhons, a resident due to dementia, was not capable of consenting to sex. The home accused Mr. Rayhons of sexually abusing his wife and reported him to police. Mr. Rayhons contended at trial that he and Mrs. Rayhons had kissed and touched each other on the night in question but had not had intercourse. He further testified that his wife had initiated contact on several occasions. A jury found Mr. Rayhons “not quilty.”
Charging Mr. Rayhons with a crime for continuing relations with his wife seems an over-reaction. It appears tragic when, as writer Paula Spencer Scott reported in AARP Bulletin, Mrs. Rayhons died the week before her husband was charged and the family put out this statement: "Accusing a spouse of a crime for continuing his relationship with a spouse in a nursing home seems to us to be incredibly illogical and unnatural, as well as incredibly hurtful.”
Granted, determining consent is not an easy matter. The memory and communication difficulties those with dementia clearly have can make them more vulnerable to sexual exploitation. On the other hand, research confirms that those with dementia do not automatically lose their desire for intimacy. Conversely, the research affirms the positive effects of touch on those with dementia. This positive effect can include sexual touching.
Since experts do not agree, nursing homes struggle to find the questions that should be asked to determine if consent exists when two people, one with dementia, indicate an interest in a sexual relationship. Common sense seems to dictate that, if either person displays signs of distress, emotional withdrawal, fear, loss of appetite or recoil from touch, this may indicate a lack of consent. Similarly, if the person with dementia has previously rebuffed unwanted sexual contact but signifies verbal or non-verbal acceptance of this contact, this is an indication that knowing consent is present.
The Sandra Day O’Connor Case
Perhaps more difficult is the situation known as the “Sandra Day O’Connor Case.” Here the spouse with Alzheimer’s forgets the partner entirely and becomes involved in a romance with a fellow resident in the nursing home. If the family can be counseled to understand that an Alzheimer’s patient is living in the moment and in the mind has regressed to an age where he or she is not married, this can make this challenging circumstance easier to accept.
When Justice O’Connor faced this situation with her husband, she was charitable, even heroic. She was glad that the relationship was bringing her husband happiness in spite of his dementia.
The Task for Families
Knowledge that sexual issues are present with long-term care in a facility, acceptance of that fact and emotional maturity in reaction to how it presents itself in a particular family can help alleviate the angst involved. Forcing a family member to give up a relationship or insisting that the nursing home take steps to do so, can often create harm for the resident.
Kent Haruf’s novel Our Souls in the Night poignantly depicts a heartbreaking story in which son, Gene, forces his 70-year-old widowed mother, Addie, to give up a relationship with Louis, her widowed next-door-neighbor. Gene, repelled by the liason, refuses to let his mother have contact with her grandson, as long as she is involved with Louis. Addie feels she has no choice and caves and everybody loses.
The task for families is to face sex among the elderly as a fact of life and deal with it.
Sandra W. Reed is an attorney with Katten &Benson, an Elder Law firm in Fort Worth, Texas. She lives and practices in beautiful Somervell County, near Chalk Mountain. She can be contacted by phone at (254)797-0211 or by email at swreed2@yahoo.com. ..Source.. by Sandra Reed
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