Sexual activity between dementia residents, (news article)

carolinasweetheart88 · Jul 23, 2013

I currently have this type of issue right now at my facility. No legal issues as of now, the rsdts are often seen holding hands and kissing. I personally have not saw the kissing but worry that this same thing could happen if it isn't addressed. I've only been at this facility for a month. I am going to speak to my unit manager when I work next.

CapeCodMermaid, RN · Jul 24, 2013

People crave physical contact even when they're old and have dementia. We have many residents who hold hands. On occasion, a kiss between two residents with dementia. Since Massachusetts is full of Puritans, the DPH considers that a reportable event. I've worked in places where residents apparently wanted to do more than hold hands. No problem if they are both alert and oriented. These residents were not. We ended up having a meeting with their health care proxies. They gave consent for the residents to "do whatever made them happy". I hope my HCP is that forward thinking if I'm demented. These residents apparently forgot they wanted to have sex so nothing ever happened.

MrChicagoRN, RN · Jul 25, 2013

If someone hasn't the capacity to consent, it can be tricky, but I do support the right of seniors to be free to express their sexuality like anyone else

this place looks interesting:

Sex in Geriatrics Sets Hebrew Home Apart in Elderly Care - Bloomberg

northshore08 · Jul 25, 2013

I have a lot of questions about this issue, and I am probably wrong about a lot of my thoughts, so I came here for clarification. My experience is hospital based, ED and OP. If residents are in the nursing home because they are demented and cannot care for themselves, how can they go farther than hand-holding or hugs? I understand the need for close human contact, but we don't allow minors to have intercourse (unless I am wrong) and aren't demented patients in that same category? Are dementia patients considered consenting adults? I think about surgical consents, where these patients cannot consent for themselves, their POA or family has to be present and consent for them. I learned Maslow just like you all did, but I don't see that sexual intercourse is the same as nutrition or cleanliness.

Help me understand all this. I like the idea of the decisions being made in conference with the HCP family members. I know if my mom had wanted to be with someone it would have been okay with me, but maybe not with my brother or dad.

lauriepat, ASN, RN · Jul 27, 2013

This is an issue in the memory care unit at my job.

The woman however is still legally married.

Management says it is "ok" for them to kiss/hold hands, etc

However a few weeks ago they were found together in the man's room with the door barricaded and from what i heard the site was horrific.

I am waiting for

A. The woman's still legally married husband to show up and for there to be a huge problem

B. probably a lawsuit.

KCMnurse, BSN, MSN, RN · Jul 27, 2013

This is a sensitive issue. The ability to consent is always implied unless there is information/documentation to the contrary. Consenting to sex is not the same as consenting to surgery. Adults with dementia are not the same as children. If there are concerns then the team should meet to discuss the situation. This is not a one size fits all situation. We have to put our personal views aside and determine the best situation for the patient.

northshore08 · Jul 28, 2013

Thanks so much for your responses! In my experience, choices concerning patient care for those who are not able to consent for themselves rests with their health care proxies or with the next of kin. Is that not the case in LTC facilities? I can't see how consent can be implied for dementia/Alzheimer's patients who cannot consent for themselves.

miasmom · Jul 31, 2013

Walked into a room. Man on top women. All clothes on.He spooke language a. She spoke language b. Both denrntia. He keft room.embarrassment. I ask female is she was ok. Her reply.....he was good. But sister was better!

KCMnurse, BSN, MSN, RN · Aug 1, 2013

Walked into a room. Man on top women. All clothes on.He spooke language a. She spoke language b. Both denrntia. He keft room.embarrassment. I ask female is she was ok. Her reply.....he was good. But sister was better!

Would I be wrong to call that consensual?

miasmom · Aug 8, 2013

I know they had urges. Both very confused and unable to make decisions. Try explaining it to family. Another note. Had an anotherolder male holding hands with a female. Wife came in for a visit like she always did. Saw it. She let him have it. Had to explain he could not remember she visits daily.

*LadyJane* · Aug 8, 2013

I imagine the wife would be upset, but she also needs to realize that her husband is not able to remember what he ate for breakfast, either. Demented residents need protection, but what are we proteting against? The wife's feelings, or the husband's momentary(?) comfort at holding hands with a female resident.

Also, in that "horrific scene", were they naked? what exactly was going on? sexual intercourse? Bondage? Beating? Kissing andhugging?