Let public have say on sex in SNFs, researchers say

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Current policies on how intimate relationships should be handled in nursing home settings have “failed” residents and the public alike, according to research published Wednesday.

The topic of sexuality is one that's “seldom considered,” in nursing home environments due to barriers such as negative attitudes, lack of knowledge and few resources to develop policies and train staff, according to researchers at Kansas State University's Center on Aging. The topic is often further complicated when a sexual relationship involves a resident with dementia, “who may lack sexual consent capacity, or the ability to make ones' own sexual decisions.”

The research team cited the case of Henry Rayhons, who was accused and eventually found not guilty of sexually abusing his wife, who had dementia and lived in a nursing home. The lack of long-term healthcare policies on sexual expression “failed” the Rayhons, wrote lead author Maggie Syme, Ph.D., and leaves the issue of sexuality in nursing settings “largely ignored.”

Syme's team, which includes researcher Gayle Doll, Ph.D., analyzed comments posted online in response to the New York Times' April 2015 story on Rayhon's case. The comments — just over 1,000 of them — sparked a discussion on what conditions are necessary to engage in a sexual relationship, as well as consent.

More than two-thirds of the commenters on the NYT story responded that they were in favor of sexual expression in people with dementia, showing that “the general public wants this supported in long-term care settings.”

“This majority opinion may be in direct opposition to those ‘in charge' of practices and policy-making in nursing homes (eg administrators, accreditors) who have often taken a paternalistic stance towards sexual expression for individuals with dementia, resulting in prohibitive practices in many homes,” researchers said.

The study's findings suggest that policymakers and nursing home administrators alike should consider “indicators” such as a loving relationship, the impact of ageism, risk and safety when developing policies regarding sexual relationships.

“Taking this flexible, recommended approach can facilitate the development of policies and procedures that capture the resident/consumer voice, protect against harm and support safe sexual expression for individuals living in nursing homes,” Syme wrote.

The full study was published online in Health Expectations, a journal covering the public's participation in shaping healthcare policy.