Sexuality in Care Facilities

As a therapist, I have dealt with a lot of adolescent sexual issues, mostly trauma and abuse. I have seen very few seniors.

But I have started to wonder how senior care homes and assisted living facilities deal with sexuality. Is the myth that seniors lose interest in sex as they age still common? I have friends in their 80s and 90s who are still very sexually active. Is this an issue that caregivers and families should consider when placing those they love in a facility because they can no longer care for them?

What would a care facility be like if sexuality was allowed or even encouraged? In my research, I discovered that, nationally, some facilities offer classes on sexuality, give out condoms, check for STDs and even have social activities that support people dating.

As can be expected, there are concerns from families and staff. Doctors and healthcare workers often hold stereotypical views, which reduces their ability to address the sexual needs of patients, including a reluctance to discuss sexual health-related issues, which affect us all as we age and especially if we don’t happen to be heterosexual.

Perhaps the aging “free to love” Boomers have had a positive impact.

Nationwide Mutual Insurance Co. published “Consensual Sexual Relations Among Residents: Risks and Responsibilities,” a guide for care facilities to minimize risks of sexual activity for both residents and the organization, while respecting individual autonomy, privacy and other residents’ rights. The guide says, “Residents at your agency will naturally form romantic relationships and may want to express and enjoy these relationships through consensual sexual relations. The definition of ‘whole-person care’ recognizes the sexual needs of your agency’s residents.”

In his 2017 article in the American Medical Association Journal of Ethics, Eran Metzger also provides “guidelines that nursing homes can implement to support residents who wish to engage in sexual activity,” including recommendations for staff and family members of residents.

As the population ages and age-related heath concerns, including dementia, rise, the need for carepartnering is also increasing sharply. More support is needed for carepartners, especially those who have been in long-term loving relationships and are grieving the loss of the intimacy and sexuality that they once experienced.

As we lose our partners to physical or mental illness, carepartner support groups of people with shared understanding and empathy become extremely important in helping us cope with loss, including loss of intimacy.

My husband and best friend recently died of multiple physical problems and Lewy Body Dementia. Even as he became more confused, he continued to be his affectionate, humorous and sexual self. We were grateful that we had a long, adventurous life together, even if we didn’t get to have great sex until we were 100.

Marilyn Allen is an inquiring researcher in Fieldbrook.