Sex, Dementia, and the Nursing Home: Is it a Case of Elder Abuse?

When we think of elder abuse, the most common scenario involves elder caregivers, or the employees at an assisted living facility, taking advantage of a senior citizen. In some cases, abuse takes the form of physical or verbal abuse, financial elder abuse, and even sexual abuse. But what happens when seemingly consensual sexual activity takes place between two senior citizens who have been diagnosed with dementia or Alzheimer's? Where is the line between consent and elder abuse drawn? These are the questions many assisted living facilities are having to deal with as they encounter sexual activities between seemingly consensual senior citizens.

If you feel strongly about the issue in regards to a relative, or yourself when the time comes to move into an assisted living situation, make sure you understand the facility's policy regarding intimacy and sex between residents.

Please Note: The scenarios discussed in this post are cases where two residents willingly engage in sexual relationships with one another. We never condone any sexual activity between a caregiver and a client, or any instance where a victim is forced against his/her will.

Some nursing home facilities consider sex between patients a form of sexual elder abuse

This issue came to my attention while listening to NPR Correspondent Melissa Block as she interviewed Bloomberg reporter Michael Gruley about recent cases of geriatric couples being caught having sex, and the stories that have unfolded. You can read the complete transcript of the interview that captured our attention by clicking this link to NPR's All Things Considered transcript.

The first case Gruley discussed involved a couple at Windmill Manor in Coralville, Iowa. A nurse walked into a room where a couple was having sex. The man was 78, the woman was 87, and they both suffer from dementia. Family members sued, claiming it was a form of elder abuse, and the legal fallout was dramatic. Both the nursing home administrator and the director of nursing lost their jobs, the man was relocated to a new home that was hours away from his family, and the legal process took three years to complete.

As Gruley poured through hundreds of pages of evidence he noted that there was no evidence of force, or injury, and it always appeared as if the woman was willing and compliant in her sexual relationship with the male partner. In fact, when employees separated the couple, she fought, kicked, hit, and scratched trying to keep him with her. However, it was also noted that she often referred to the man using her husband's name. So, the question arose: can she really be compliant when she doesn't even recognize or seem to be aware of who she is with? Where is the line drawn between mental awareness or acuity, and free choice?

Maybe Preventing Elder Abuse Means Allowing Nursing Home Residents to Engage in Sexual Relationships

One of Gruleys comments during his interview with Melissa Block struck a chord,

"...there are two schools of thought about this. One is that, you know, if they're that confused, how can they have the capacity to consent? And another school of thought is that these are people who've become, to some degree, somebody else. They've lost mental connections with people they loved, with much of their past, but that doesn't rob them of their desire and their need for touching, for intimacy. Just because they confuse who they're with, that doesn't mean it doesn't give them some pleasure at a time in their lives when pleasure comes at a premium."

In a second article he wrote for Bloomberg, Gruley discusses The Hebrew Home, which takes a progressive stance on the subject of sexuality for seniors and their clients 'rights to physical affection, intimacy, and sex, regardless of whether they have dementia or Alzheimer's. Their policy, according to The Hebrew Home's president and CEO Daniel A Reingold, is to honor what remains in a person, rather than what has left. The company addresses each situation on a case by case basis. While any signs of overt coercion, force, or true abuse would be dealt with accordingly, The Hebrew Home feels they have no right to interfere in their clients' sexual lives.

Perhaps denying an elder the right to engage in physical, intimate, and sexual acts with another human being of their choosing is a type of elder abuse in its own right, in which case preventing elder abuse means supporting senior citizens' lifestyle choices.

One thing is clear, assisted living and nursing home facilities must begin to determine their stance, and create clear directives regarding the sexual behavior of their patients, as our nation's almost 80 million Baby Boomers head into their golden years. These were the children of the sexual revolution. They have a more liberal outlook on sex than any generation before them and are the first beneficiaries of the Era of Viagara.

Who knew that along with meal service, private rooms, and amenity options, we would also have to ask retirement home administrators, "What is your facility's stance once on sexual relations between patients?"

What are your thoughts? Do you consider sex between elders with dementia or Alzheimers to be a form of elder abuse?

Hire a Private Investigator if you suspect genuine elder abuse

If you suspect that genuine abuse, whether it be physical, emotional, or financial elder abuse, is an issue for your aging loved one, please contact licensed Los Angeles Private Investigator, Mike Garroutte. His private investigation firm, Linked Investigations, works to prevent elder abuse using pre-employment screening for caregivers, surveillance services, criminal background checks, asset searches, and more. Contact us today to schedule your free consultation.