MANHATTAN, KS — Among the many great American sex myths is a belief that certain people either no longer or never have possessed a sex drive. These include the disabled, the religious including those in Holy Orders, the young, any and all parents, and the very old. Of course, life has a way of ignoring cultural mythology – and the staff of an increasing number of nursing homes is finding ways to adjust to the reality of elder sex.Until recently, residents of nursing homes were faced with a series of nearly insurmountable obstacles to overcome before they could enjoy their natural right to partnered sensual or sexual pleasure. In addition to finding it nearly impossible to gain any real privacy, many residents have had to deal with care providers who have been outraged, offended, disgusted or merely deeply disturbed by the idea that the fragile beings under their protection might still be sexual, whether on their own or with a partner.
Given that locking doors has legal repercussions and residents often share rooms, finding a long moment for solo or shared romance can be difficult even when staff is compassionate to the touch-starved needs of its charges.
Adding to the problem is that fact that although the number of people seeking care at nursing homes continues to rise, education about the sexual needs of those people is non-existent, leading professionals to either ignore the sexuality of residents or actively condemn it.
Fortunately, experts on aging at the Kansas State University are investigating the issue and working to create ways for the aged to have a little privacy and gain a little lost respect for their inconvenient but still vital sexual urges.
Researchers Majka Jankowiak and Laci Cornelison from the Center on Aging studied three Kansas nursing homes and the attitudes of their staff on the issue of sexuality and the elderly. Their findings, which were presented during the October American Association of Homes and Services for the Aging conference held in Philadelphia, included both anecdotal feedback and structured survey responses received both prior to and after a workshop on the subject.
“They really felt this was a topic that they needed to be educated on,” Jankowiak observed to online Kansas City InfoZine. “Part of it is that American society is not supportive of older people and sex. It’s been a taboo and it’s an even bigger taboo in nursing homes. After the presentation, the participants felt more confident talking about it and dealing with sexual expression of residents.”
While some solutions may seem obvious, staffers at nursing homes have not apparently understood the importance of seeking solutions. An example provided by Infozine concerns a married couple who were able to room together, but not hold hands from their beds due to one spouse’s need to have a leg elevated. While moving the beds so that the couple’s hands would not be impeded by the lifted leg may seem a no-brainer, staff concluded that the issue wasn’t important and nothing could be done about it. Fortunately for the elder loves, an employee attended Jankowiak’s presentation and suggested that a simple furniture shift might make things right.
Gayle Doll, director of K-State’s Center on Aging, observed to InfoZine that adult children can also pose a complication to the love lives of residents. Fearing for their safety or worried about how a new relationship might affect inheritances or other family matters, children can discourage or actively condemn the very things that may help their parents enjoy a quality of life that encourages them to remain healthy and happy.
Researchers are working on materials to help family members adjust to the reality of sexually and romantically active aging relatives – as well as materials to assist both staffers and residents when grappling with the modern world of STDs, including HIV.
The prevalence of dementia and Alzheimer’s in the assisted care setting further complicate negotiating the already choppy seas of erotic impulse, given that the conditions can provoke unacceptable sexual behavior.
As Doll points out, “Even though we advocate for residents’ rights, there are things that are inappropriate. But staff must be able to handle this without residents feeling embarrassed. Inappropriate behavior can just come from people needing relationships, not necessarily sexual ones.”
With an August 2007 issue of the New England Journal of Medicine estimating that approximately 53-percent of respondents aged 65 – 74 and 26-percent of respondents aged 75 – 85 years stating that they are still sexually active, the issue of elder sexuality is not likely to go away. Given the graying of the sexually liberated Baby Boom, the topic will only become increasingly unavoidable.
Some nursing homes are employing sexual contact policies that involve a staff review of residents and an assessment of their ability to give meaningful consent.
Issues of dementia are of special concern to those in care giving roles and Dan Reingold, the executive director of Hebrew Home for the Aged in Riverdale, NY observed during the film Freedom of Sexual Expression: Dementia and Resident Rights in Long-Term Care Facilities, that “it’s absolutely critical that long-term facilities have written policies and procedures regarding sexual expression, particularly dealing with residents who have dementia, because there are so many ethical issues that arise in connection with persons with dementia.”
Doll hopes to see federal guidelines developed to assist nursing home staff and residents develop a respectful and positive policy concerning sexual expression.
