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More nursing home sex needed say old-age experts

Sep 14, 2012, 10:08 a.m.
Surprising new research from Australian scientists encourages sexual relationships between seniors in nursing and care homes, dementia notwithstanding.

LaTrobe University is way "down under" in Victoria, New South Wales, Australia. But it's right near the top of world universities as a research institution. Housed within its Melbourne campus is the organization known as ACEBAC -- the Australian Centre for Evidence Based Aged Care. This group with the long-lettered acronym is focused on "... developing and evaluating guidelines for Best Practice in service delivery and organisation in aged care." In short, they research ways to improve elder care and to identify best practices.

A "best practice" is a method, technique or process that delivers the most-wanted results. Best practices exist in almost every discipline from chemical engineering to human resource management. ACEBAC is on the hunt to find how elder care can be delivered to the greatest benefit of the elderly and to society. Last week they reported in the Journal of Medical Ethics that barriers to sexual relations between elderly folks in nursing homes are "concerning" and that seniors are frequently denied sexual relations due to staff's fears of repercussions.

Repercussions? Yes, including fears that sexual relations and other intimate activities for the elderly in a nursing home may lead to safety and health issues such as STD's. Fears that relatives may view sexual relationships as a failure of the care facility to "police" its residents and that the "failure" may lead to litigation. Fears that a resident may be coerced into a sexual situation; after all, dementia reduces one's ability to make wise decisions.

Researchers at ACEBAC point to the inherent human right of sexual self-determination, especially for those living in elderly and nursing homes. Each of us throughout our lifetime are able and have every right to establish relationships with others and engage in lawful sexual behaviors without outside restrictions. Yet when a senior enters a care facility he or she finds that ...

  • Privacy is difficult or impossible to obtain
  • Staff actively works to prevent the development of intimate and sexual relationships
  • Staff, in general, treats residents as children who need to be managed rather than as adults

One reason care home management feels that restrictions and supervisory oversight are needed is that so many residents suffer from dementia. Yet the ACEBAC scientists explain that restrictions are "... a violation of the fundamental right of a person with dementia to be recognized as a person before the law." They argue that staff in care facilities should make every effort to prevent harm to residents, yet should also acknowledge and honor the rights of seniors (with or without dementia) to make their own decisions about intimacy, their own sexuality and their physical and romantic relationships.

What say you? Sexual relations among care facility residents is a controversial issue. People commenting on the journal article and visiting subsequent news reports on the web generally agree that the elderly should be able to forge their own relationships, and that care facilities need to respect their decisions. One woman remarked, "... If I outlive hubby and I make an attachment to another man why the heck shouldn't I be able to have a sexual relationship with him? It was never an issue before I married and it shouldn't be after my marriage comes to its conclusion. Being a widow is not going to change my need for affection including physical affection."

Yet some more conservative people argue that intimate relations should be reserved for people who are married -- even though most seniors are widows or widowers by the time they move into a care facility.

Either way, it's a question that needs new thinking and regulations to balance human dignity with safety and consideration for all elderly residents.

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