sexual harassment from mentally incapacitated patients

[aimesRN]

I am a home health nurse that usually works with pedi patients. My pt now is older than what i usually work with and he is becoming increasingly harder to handle. I understand that young men aren't completely in control of their sexual organs but he is becoming more aggressive when I have to change his diaper. Constantly trying to grab himself and thrusting at me when he is rolled on his side. I am unsure what to do or who to talk to about it because the mother still thinks of him as a baby because of his condition. He is a lot more with it than she cares to admit so I just don't know what to do other than to remove my self from the case. Any advice on how to handle the situation will be appreciated.

[Ruas61, BSN, RN]

Have you discussed this with your agency supervisor or support staff? Any other caregivers noting this?

[KelRN215, BSN, RN]

How much understanding does he have? I once had a teenager with severe autism who- all day long- would talk about how he wanted to touch himself or would stick his hands down his pants. Fortunately, he went to a school for children with autism and they taught him how that was to be left for "private time." So when he would bring it up, we would redirect him and he would remember that it wasn't private time. I cannot tell by your post if your patient has enough cognition to be taught this. I'm not sure I'd call this sexual harassment though.

[Twinmom06, ASN, APN]

even babies feel pleasure when their genitals are stimulated by anything - it doesn't mean anything. If he's still wearing diapers as a teenager, chances are he's not cognizant of anything other than pure stimulation. The hormones don't stop because he's mentally incapacitated. I'd ask your agency how this is handled, but harassment its not.

[BSNbeauty, BSN, RN]

It is hard to say what to do in this case. Does he do this with his mother? I'm not sure if it voluntarily or unvoluntarily.

[Esme12, ASN, BSN, RN]

Welcome to AN! The largest online nursing community!

I am not convinced that his behavior is intentionally sexual nor is it harassing. Even little babies, especially male babies, will reach and play with their genitals the second that diaper is off. Children will play and touch themselves in exploration with NO sexual awareness...only that it "feels different" and pleasurable.

Older boys will masturbate, have dreams and excrete semen long before real "desire" or awareness is present. It is normal behavior. Developmentally delayed patients will also have these feeling and functions with little to no sexual awareness and are only responding to biological functions/feelings.

I think you need to speak with the agency and set up a metting with the parents to see how to best handle this new behavior.

Sexual harassment? I do not think this is the case for this patient.

[xoemmylouox, ASN, RN]

That is a tough one. I would speak with the case manager about your concerns.