I found out today that two of the residents in my ALF have been.....well......canoodling in the female resident's apartment every chance they get. Now, it's not that I personally have a problem with it; after all, they ARE adults, and old enough to be my parents. In fact, they both are in great physical health and---I've got to admit it---look absolutely adorable together.
The trouble is, a) the female resident has the short-term memory of a flashcube---she's quite a long way down Alzheimer Road; b) the male resident isn't much better off than she is cognitively (although evidently the rest of his body works just fine!); and c) the male resident is married---the wife is in another ALF across town, and even though she's reportedly a witch of a woman, the resident's daughters would FREAK if they knew of this affair.
I'd like to hear some perspectives from other DONs/DNSs who have dealt with this sort of thing before. I wouldn't be concerned if it were merely a matter of morality; unfortunately, given these residents' cognitive deficits, I'm worried about the ethics of it all. There is absolutely NO evidence that the intimacy is unwelcome; in fact, they have been heard enjoying each other's company, and it is obviously mutual. But given the fact that she is incapable of independent judgment, how consensual can a physical relationship actually be? Where does it cross the line and become sexual abuse? Does his dementia make it even more of an issue, or less? And do I have to report any of this, either to the state or the residents' families? (Both of them have children with POA.)
Even my boss isn't sure of what to do here............this relationship is certainly not exploitive, and we don't want to interfere if we don't have to because of the obvious benefits of sexual activity. But given the diminished mental capabilities of both people involved, we wonder what, if anything, we are supposed to do about it. Please help if you can......as a relatively new nurse-administrator, I've not yet had the dubious pleasure of dealing with this situation in my current capacity. Thanks!
