[CapeCodMermaid]

I hope someone can give me some advice. Like you all, I have a building filled with older people. Just because you're past a certain age doesn't mean you should have to give up being sexually active. Just because you are demented doesn't mean you should be made to go without some sort of sexual activity for the remainder of your life.
But, what's a DNS to do? We have several demented men on the unit who are looking for sex...with anyone...eachother, themselves,whoever.
I'm not being fresh or making a joke...is there a regulation about this? If they can't legally consent to taking their medications because their healthcare proxy has been invoked, or they have a guardian, can the guardian consent for them?
Psych services has not historically been helpful for these residents. They suggest female hormones or other kinds of medication which are usually given to sex offenders in the community. From the little I know, these drugs just take away the ability but not the desire so they are of no use to my residents.
Any advice would be gladly welcome.

[txspadequeen921]

I could tell you some stories about this... Lord have mercy. I had a couple not married in a Alzheimer's facility that both were demented but not enough that they had forgot about sex. Anyway they would have sex 3 times daily after every meal and we had to provide them privacy because both of the families consented....Lets not forget here both were incontinent and would rip each other brief off and get after it.....To make it even better the females family was ok with it but wanted "mother" monitored so he wouldn't get to aggressive with her....So we had to peek in to make sure all was well.... It was like peeking into a live porno show.. And the staff was worried that "mother " was gonna rape the man ..cause she was a freak. Not the other way around. When they were done they would flip the light on and request to be cleaned up and have their sheets changes...and I'm not kidding. We called the state (Texas) and they told us that we have to allow them privacy and give them a place to get busy in. I fought this and fought this cause both were incont and he would take her diaper off and get busy even if she had BM on her.. I was overruled and she ended up getting a systemic infection about 1 month later (after we had a positive vaginal infection going) and she died. He died as well about 3 months later. There is my little tid bit on Geri sex don't know if that can help you or not...

Originally Posted by CapeCodMermaid

I hope someone can give me some advice. Like you all, I have a building filled with older people. Just because you're past a certain age doesn't mean you should have to give up being sexually active. Just because you are demented doesn't mean you should be made to go without some sort of sexual activity for the remainder of your life.
But, what's a DNS to do? We have several demented men on the unit who are looking for sex...with anyone...eachother, themselves,whoever.
I'm not being fresh or making a joke...is there a regulation about this? If they can't legally consent to taking their medications because their healthcare proxy has been invoked, or they have a guardian, can the guardian consent for them?
Psych services has not historically been helpful for these residents. They suggest female hormones or other kinds of medication which are usually given to sex offenders in the community. From the little I know, these drugs just take away the ability but not the desire so they are of no use to my residents.
Any advice would be gladly welcome.

[mercy1975]

Originally Posted by CapeCodMermaid

I hope someone can give me some advice. Like you all, I have a building filled with older people. Just because you're past a certain age doesn't mean you should have to give up being sexually active. Just because you are demented doesn't mean you should be made to go without some sort of sexual activity for the remainder of your life.
But, what's a DNS to do? We have several demented men on the unit who are looking for sex...with anyone...eachother, themselves,whoever.
I'm not being fresh or making a joke...is there a regulation about this? If they can't legally consent to taking their medications because their healthcare proxy has been invoked, or they have a guardian, can the guardian consent for them?
Psych services has not historically been helpful for these residents. They suggest female hormones or other kinds of medication which are usually given to sex offenders in the community. From the little I know, these drugs just take away the ability but not the desire so they are of no use to my residents.
Any advice would be gladly welcome.

Sexual Expression of Elders in the nursing home is an area which we will all need to have guidelines and assessments soon. The baby boomer generation is coming!! Residents have the same rights as all of us. Cognitive loss does not mean lose of feelings.Sexuality is a universal human characteristic that extends througout a person's life.Residents are seeking comfort, companionship, and human closeness.

Each facility will need to assess the resident to assure they can give consent.The staff will need education. Families and /or responsible party, the physician, and psychiatrist will all need to be involved.

Online are sources that discuss memory, cognitive skills and sexuality, The "Sexuality Expression Questionaire, Decision Tree for Assessing Competency to Participate in an Intimate Relationship, and Sexuality and Intimacy Worksheet. Just search these titles and you should be able to find.

Policies and Procideures will need to be developed. Staff education and discussion will be very important. No matter what the moral beliefs are of staff, residents have the rights for sexual expression. Of course, sexual expression is only appropriate when done privately.

I know of a facility that had two men who wanted to share sexual expression. After proper assessment and determining ability to give consent, these men were allowed private areas.Luckily there were always some staff who were availiable to provide this private time for them.

Sexual Expression is one of the residents rights. However no resident can be unsafe, exploited, or injured, physically or emotionally.

[rn/writer]

For those residents for whom sex is not a safe option, there are many meds that decrease desire. Sometimes such meds are given to dementia patients who become aggressive in their quest for sex and become a danger to their fellow residents.

[nckdl]

I have personally been down this road with my residents. The male, since he was more aggressive he was put on Tagament because it took away the "urge to have sex" not the ability. I hope this helps.

[noc4senuf]

I have been down this road many times over the years. Yes, we always did get family consent if the resident did not have the cognition or right to do so. I remember back in the 70's when the health care center i worked in also had a psych ward besides the regualr geriatrics. The female of the duo was of child-bearing age and we had her on birth control to prevent a pregnancy (she was a long-term care resident).

I have also had the incontinence issue brought up. Luckily it did not cause a death but, it did involve oral sex. There have also been problems when catheters are in the way.

I wish you luck with your decisions.

[Boopette RN]

•A basic human need of people of all ages is intimacy. Romantic intimacy and sexual needs of older adults are often ignored by health care professions for several reasons: sex is not seen as a priority by either the resident or the provider, sexual concerns have not traditionally been addressed by health care encounters, and sexuality is seen as separate from health care concerns. Anxiety and fear of embarrassment prevent residents and nurses from bringing up sexual concerns.

Sexuality does not end when a resident gets admitted to a nursing home. Our residents are somewhat limited in the manner they can express sexual desires. They may have lost their spouse or significant other and have no one, or now have to live away from them. This is difficult for any one, but especially difficult for elders who now have to live in a nursing home.
Some residents because of medical conditions have lost the mechanism in their brain that stops them from saying and doing inappropriate things.