Residents and sex: It's time to re-examine what's appropriate

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John O'Connor
John O'Connor

It's so easy to think of older people as being done with sex. And truth be told, many are. But as anyone who has spent time in a skilled care setting can attest, that's hardly a one-size-fits-all notion.

The reality is that plenty of residents remain frisky later in life, as do many non-institutionalized spouses. Some are sound of mind. Others, not so much. So what should the role of nursing homes be when two adults want to do the dance that can't be named? Especially if one of the participants has dementia?

The outcome of a recent trial should make it clear that it's time for many caregivers to reconsider whether and how to intercede.

In Garner IA, a jury has acquitted Henry Rayhons of charges that he had sexually abused his wife. A farmer and former state representative, the 78-year-old Rayhons had been accused of having sex with his wife at Concord Care Center, eight days after staff members told him that her Alzheimer's made her cognitively unable to consent.

This is one of those cases that nobody feels good about. And let's face it, the issue is not one too many of us feel comfortable chatting about in public.

But it does raise a very real question: What, exactly, are skilled care providers supposed to do? Stop something they think is wrong or inappropriate? Or look the other way? It seems either response leaves a lot to be desired.

I talked to a social worker I know for some guidance. Her advice was that facilities should set very clear, specific policies on the subject, to include talking with families in detail about the issue.

To be sure, such conversations will require that uncomfortable questions are asked. In other words, it could mean a humiliating experience for all involved. But compared to a very real alternative – forcing a jury to decide in a public courtroom – it's probably a much better option.

I'd be curious to hear how your community deals with this issue. Please feel free to share your thoughts and ideas.

John O'Connor is the Editorial Director at McKnight's.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.