Helen, a resident in a senior care community, is 60 years old and living with dementia. She has a boyfriend whose room is down the hall. He’s in the early stages of Alzheimer’s. A family member is appalled when she sees Helen kissing her boyfriend – and suspects there has been some sexual activity.
Yvette Evans-Wiggins is the Director of Nursing at The Villages on MacArthur, a Stonegate Senior Living supported community, where Helen lives. She explains the situation this way: “Helen’s family member doesn’t believe the relationship is a good idea for Helen. ‘It’s not ladylike,’ the relative says. ‘Can we put Helen on medication so she doesn’t have these urges?’
“People often think that after a certain age, sex isn’t something that seniors need,” Evans-Wiggins says. “But sexual health is just as important as physical, mental, and spiritual health – at any age. Senior living communities are often a setting that reawakens this part of a senior’s life.”
Ensuring Privacy
“Disease processes such as Alzheimer’s are hitting people at an earlier age, and our resident population is getting younger and younger,” Evans-Wiggins says. “Sexual urges are often still intact.
“Residents in senior living settings need to be supported in making their own decisions about sexuality. Intimacy may be conveyed in several ways, from holding hands to having sexual intercourse. We want to ensure residents have the privacy they need to express themselves sexually, if they want to.”
Privacy is easier to ensure in assisted living communities, where the doors to rooms lock. For residents in memory care communities, rehabilitation centers, nursing homes, and skilled nursing facilities (SNFs), doors do not lock so that staff can reach residents quickly in case of a medical emergency. “The challenge in these communities is to ensure staff respect privacy when the door is closed – and to allow plenty of time before entering the room.”
Sometimes romances are brief. For example, two residents in short-term rehab may “hook up” and end the relationship when one or the other returns home. Or long-term residents may form relationships and later break up. “It’s not much different than what goes on in the world at large,” Evans-Wiggins says.
Educating Staff
Staff are specially trained in how to handle sexual issues with residents. If a staff member accidentally walks in on a sexual encounter, procedures are in place for what to do next. A social worker and psychologist are part of the team to help staff navigate difficult situations.
“Our goal is always to make sure that privacy, dignity, and safety are respected,” Evans-Wiggins says. “If we’re aware that two residents are having a sexual relationship, we make sure it’s consensual. Some residents may not be physically or cognitively able to agree to sexual activity.
It’s also important that staff reinforce safe sex practices with residents, such as using condoms, to avoid sexually transmitted infections (STIs).
“Safe sex campaigns have been prominent in recent years, but seniors are typically not part of the target audience,” Evans-Wiggins says. “Efforts to increase awareness are increasingly important for seniors, as STIs in this demographic are on the rise.”
Enlightening Families
Children of seniors may have trouble believing that a parent is still interested in sex or is sexually active, especially if their loved one is experiencing cognitive decline or physical issues. Talking it over with mom or dad may be awkward, but critical.
“If you suspect that your parent is having an intimate relationship, it’s important to address sexuality issues in an empathic, nonjudgmental way,” Evans-Wiggins advises. “Ask questions with sensitivity – and help your parent make decisions on his or her own terms. For example, you might say, ‘Let’s talk about your new relationship. Are you getting the privacy you need to spend time together? Are you practicing safe sex?’ As you get more comfortable talking about what’s really going on in your parent’s life, you can be assured you’re helping them make the most empowering decisions about their sexual health and relational wellbeing.”
Resources:
https://www.nejm.org/doi/full/10.1056/NEJMoa067423
https://www.aplaceformom.com/blog/9-21-15-aging-sex-through-the-eyes-of-a-psychologist/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283937/
https://www.nia.nih.gov/health/sexuality-later-life
http://www.berkeleywellness.com/self-care/sexual-health/article/seniors-sex-and-stds
