Sexuality in nursing care facilities

Older adults are sexual beings. And yet the attitudes of nursing home staff may be a barrier to their continued health and satisfaction. Seniors contend with many obstacles to expressing their sexuality : disabilities ; adverse effects of prescribed medications ; cognitive impairment and a lack of privacy in a home where residents may be encouraged to leave their doors unlocked and socialise in public spaces. Policies are often lacking to help staff deal with situations when romantic or sexual behaviour is displayed. Furthermore, a study(1) shows that staff find it easier to accept behaviour that seems to be « romantic » as opposed to that which appears to be « erotic ».

In the absence of guidelines, staff often turn to the patient’s family, who then decides whether a relationship should be allowed to continue or not. Even if the patient is in an assisted home because of a physical and not a cognitive deterioration, it may be the family’s wishes that are paramount. The issue is not an easy one in the nursing home context, especially if dementia is involved. Sufferers may lose their inhibitions and engage in inappropriate behaviour, potentially leading to aggression and physical injury.

Suggestions for the ways forward include : examining one’s own attitudes towards sexuality in older patients ; improving education ; establishing guidelines concerning residents’ and families’ rights and what the care home’s responsibilities are.