Sex no longer a taboo subject at nursing homes

(Agencies)
Updated: 2008-12-23 11:37

"My greatest interest is to promote dignity in a situation that can be very challenging," Claassen said. "We all need touch, kindness and companionship. We try to enable that in this setting, which can be very public but where there is still a need for privacy."

Sexuality doesn't always mean intercourse. Many lonely or depressed residents are simply looking for ways to relieve loneliness and depression, Doll said.

For example, she told of one resident who had asked for pornography but dropped the request when the staff started spending more time with him.

"The staff can help with the loneliness and need for connection that residents often have," Doll said. "Some sexual expressions that might be seen as inappropriate will go away when they simply get the attention they deserve."

When the need does include sexual activity, the issue becomes more difficult if one of the residents is suffering from dementia, advocates say. That can manifest itself in a resident making passes at a staff member.

Claassen said her staff is trained to respond politely and to understand that the impaired resident may be mistaking the staff member for a spouse or reacting as he or she has in the past, which is often more vivid than the present for those suffering from dementia.

If a resident with dementia becomes involved with another resident, the issue becomes determining if the sexual activity is consensual, said Robin Dessel, a national expert on dementia who is the director of memory care at Hebrew Home in Riverdale, N.Y.

Dessel said people with dementia, even those who can no longer speak, have wants and desires and the ability to express them. It takes a trained and educated staff to recognize if a sexual overture or relationship involves abuse or is borne of real need, she said.

Dessel said she has seen a growing awareness that the aging do not forfeit their rights as they become infirm, and that includes the right to express sexuality. She expects that trend to increase as baby boomers, with more liberal attitudes toward sex than their parents, continue to age.

"No matter what we see, even if someone needs total care or is incontinent, they still feel," Dessel said. "If there's a bonding with someone else, I think it's a time of celebration at that point that there's something left, something good and pleasurable for that person."

To meet that challenge, clinicians and providers need some standardized parameters to use to assess patients' consent, Dessel said.

The Kansas State researchers say federal guidelines should be developed to help nursing homes deal with sexuality in a positive way.

"Nursing homes are the second most regulated industry in the country, behind nuclear power plants," Doll said. "But none of those regulations address sexuality. So, consequently, no one knows how to handle it."

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