Sex Among Residents in Nursing Homes Increasing

loving senior couple

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Sex among residents in nursing homes and other long-term care facilities is still a taboo subject. Yet it happens. A lot!

Many older Americans routinely engage in intercourse, oral sex, and masturbation, according to a federally funded study published by the New England Journal of Medicine. Researchers found that 73 percent among those 57-64; 53 percent among 65-74 and 26 percent of those 75-85 said "affirmative" to sex. One in seven were using drugs to increase performance.

For older people with dementia living in residential aged care facilities (RACFs), the issue becomes more complex. Staff often struggle to balance residents' rights with their duty of care, and negative attitudes towards older people's sexuality can lead to residents' sexual expression being overlooked, ignored, or even discouraged. In particular, questions as to whether residents with dementia are able to consent to sexual activity or physically intimate relationships pose a challenge to RACF staff, and current legislation does little to assist them.

Nursing Homes Helping Patients With Their Romantic Relationships

A survey of 250 residents in 15 Texas nursing homes found that eight percent said they had sexual intercourse in the preceding month and 17 percent more were wishing they had. In the Journal of Clinical Geriatrics, 90 percent of 63 physically dependent nursing home residents said they had sexual thoughts, fantasies, and dreams.

At the Hebrew Home in New York, Daniel Reingold, president, and CEO relates that when the staff learned of coupling in the works they don't wait for residents to ask for a private room. They relocate one of the partners to a private room if both are in shared rooms. In his 1,000 resident facility, he knows of a dozen romances. The policy is grounded in the understanding that this is a resident right. "Anything people might do at home they're allowed to do here."

In the journal Topics in Geriatric Rehabilitation, researcher and Professor Robin Stadnyk found that non-institutionalized spouses and their institutionalized partners remained very close defying the common assumption that marriage ends when one spouse enters a care facility.

Nursing homes need to nurture this. Provide quiet, private spaces, adopt privacy policies, knock before you enter, help them find things to do together. Have a written policy, train staff, and protect vulnerable residents.

Many nursing-home workers simply don't look at the elderly as mature adults, but as children who must be policed out of fear of legal or medical repercussion.

Nursing Homes Need to Keep Up With a Changing Society

People are living healthier and longer. Mores are more liberal. There are widely accepted treatments for sexual dysfunction and older adults refuse to accept loneliness as a condition of aging. Television and the dog can only do so much. Even the world condition seems to be drawing people together. The impact of national disasters has been cited as another reason why older adults are seeking the safety and comfort of intimacy. And the mass shootings of recent years only exacerbate a need for closeness. There are some unintended consequences as well. AIDS cases among those 50 and older account for 13% of all cases.

The Hebrew Home through a grant from the New York State Department of Health created a comprehensive staff training video/DVD called "Freedom of Sexual Expression: Dementia and Resident Rights in Long-Term Care Facilities." The Home's policy and video provide the educational foundation and standard of practice for residential health care facilities across the state and the nation. Might be worth a look.

Providers walk a fine line balancing person-centered care with risk management. Yet risk can be minimized with sensitivity and empathy toward resident needs.

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