Consensual Sex In Elderly Care Homes - Ageism And Safety Concerns

Date: Jun-25-2012An article published in the Journal of Medical Ethics reveals that elderly care home residents are often needlessly denied consensual sex because of concerns regarding safety and ageism.

Researchers from the Australian Centre for Evidence Based Aged Care state that even though elderly people, including those with early stage dementia, often still enjoy a sexual relationship in their own homes, but once they move into residential care, a sexual relationship is often frowned upon.

The researchers say that factors, such as safety fears, insufficient privacy, concerns about duty of care, anxieties about potential repercussions from relatives, and ageism often take away people's "basic human right", standing in the way of "a normal and healthy part of ageing."

They write:

"Since it has been well established that sexuality and intimacy continue to be important in later life and are central to an individual's health and wellbeing, the lack of attention paid by aged care facilities to residents' sexual needs is concerning."

According to the findings, residents do want acknowledgement of the fact that they may be sexually active, and they also believe that healthcare professionals should enquire about their sexual needs. However, they state that many residential facilities have insufficient formal policies, guidelines or appropriately trained staff to deal with the issue. In addition, care home residents also have to overcome hurdles, such as existing frameworks to assess their mental capacity and consent, even though these are primarily in place to make important decisions like therapies and power of attorney.

The researchers state that the few frameworks that are in place to assess decision-making capacity with regard to sex are unsuitable. They argue that even though an individual may have a bad score on a mini mental state test, which is used to assess cognitive impairment, these people are often still capable of expressing preferences for a friend or lover.

Even though the researchers realize that it is important to consider that those who are vulnerable need to be protected from harm, and that it has to be ensured that sexual behavior is neither harmful, abusive nor illegal, they argue that it should not prevent people with dementia from making their own decisions about sex.

Regardless of the risk that some care home residents may suffer emotional distress if a relationship ends, they state:

"However, these are risks that any sexually active person faces throughout his or her life, and we should not confuse a bad or unwise decision with incompetence. Seeking to 'protect' individuals with dementia by not allowing them to express their sexual needs, thereby stifling their autonomy and personhood, is a far greater failure of duty of care. It is also, we would argue, a violation of the fundamental right of a person with dementia to be recognized as a person before the law."

The researchers state that these matters will probably become more urgent and relevant as the population ages and with an increasing need for more residential care homes. They conclude: "At present, rather than engaging with the delicate balancing act between resident autonomy and duty of care [residential care homes] are choosing to ignore the issues and tread on the side of caution."

Written By Petra Rattue

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