Psychologists open up about LTC sex and dementia

Here’s my latest article on McKnight’s Long-Term Care News:


Psychologists open up about LTC sex and dementia

A recent Iowa court case acquitted Henry Rayhons of sexually abusing his wife, who had Alzheimer’s dementia and lived in a nursing home. The case not only prompted national debate, it led those in long-term care to consider how to handle sexual activity within the bounds of their facility, particularly in cases when one or both of the parties have a diagnosis of dementia.

Psychologists are frequently asked to determine whether or not a patient has the capacity to understand or authorize various aspects of care, including their ability to consent to sexual behavior.

Eric Redlener, PhD, president of The PsychAssociates Group, a company that provides psychological services to long-term care facilities, held a meeting for its supervisors to discuss the challenges that arise when considering capacity, sexual activity and the senior living environment.

I was on the conference call since I work for them regularly. Here is a fly-on-the-wall account of the concerns raised during the meeting.

Staff issues

Some of the challenges to handling sexual behavior in the long-term care environment involve the reactions of staff members to the situation.

· Some staff members show squeamishness about “Grandma and Grandpa” having sex.

· Staff members may be concerned, rightly or wrongly, that residents will be taken advantage of.

· Staff members project their notion of sex onto elders. Elders may be content with holding hands or heavy petting, but staff might be anticipating people “swinging from the rafters.”

· Sometimes an administrator or director of nursing bans sexual activity among the residents, considering it “bad behavior,” despite the fact that it’s a legal right in many states for residents to be able to engage in sexual relations within a long-term care facility.

Family concerns

The reaction of family members to the romantic/sexual involvement of their elders can vary greatly.

· Some family members are able to accept their loved one’s need for intimacy, despite its sometimes unexpected expression, such as when an elderly heterosexual mother spends time cuddling with another woman on the floor, or a husband with dementia becomes involved with a woman who is not his wife.

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Psychologists open up about LTC sex and dementia

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