“Touch is one of the last pleasures we lose,” said chief executive of the Hebrew Home at Riverdale, in the Bronx, which pioneered a “sexual rights policy” for residents in 1995. “So much of aging and so much of being in a long-term care facility is about loss, loss of independence, loss of friends, loss of ability to use your body. Why would we want to diminish that?”
Several experts described intimacy as an almost primal instinct, like eating. “Wanting to have sex is a bit like being hungry or being thirsty.”
Unless people are in a “vegetative” state, said a forensic nurse at the University of Alabama at Birmingham School of Nursing, “there’s a lot of things they might not be able to do like money and time and recognition of children, but they have the capacity for self-determination and intimate relationships.”
The director of the Center on Aging at Kansas State University, said a person with dementia might not assent with words, but with body language or facial expression.
“In a nursing home, it doesn’t happen like ‘wham bam thank you ma’am,’ ” she said. “The staff, they know the cues, they know what’s happening in the person’s relationship.”
She trains facilities in practices like knocking before entering residents’ rooms. One home even put mattresses on the floor to provide a safe place for residents who might otherwise fall out of bed.
Aging baby boomers “are going to want to have sex, and they don’t want to play bingo,” a doctor said. Yet many nursing homes have no sexual intimacy policy.
Most of them are embarrassed by sex. Older persons are not considered to be sexual.
An exception is the Hebrew Home, where staff members are asked to assess consent with nonverbal cues, to note a resident’s mood after sex, and to pose questions like: “Do you enjoy sexual contact?,” “Do you know what it means to have sex?,” and “What would you do if you wanted it to stop?”
“I’ve definitely had family members who have gotten very aggressive opposing our position in encouraging intimacy,” an official said. But staff members will tell family members, “Look, Dad is happy. Why would you want to deprive him of this?”
In other facilities, though, the official said: “I find staff members saying ‘It’s wrong. Old people don’t do this, they had spouses in the past, they have family member that would be concerned.’ ”
“Sometimes they will say to the resident, ‘Do you really want your daughter to know about this?’ And the staff members do really and truly believe they are doing the right thing.”
Dementia can cause some people to become sexually disinhibited, so facilities like Hebrew Home monitor patients to prevent situations that threaten or make other patients uncomfortable, such as patients masturbating in public rooms.
Experts say adult children whose parents are in second or third marriages may have more difficulty condoning sexual activity with the newer spouse.
Accusing a spouse of a crime for continuing a relationship with his spouse in a nursing home seems to us to be incredibly illogical and unnatural, as well as incredibly hurtful.