Safety fears and agism denying care home residents right to consensual sex

June 26, 2012

Concerns about safety, and ageism, are needlessly denying elderly care home residents what is often one of their few remaining pleasures - the right to consensual sex - say specialists in the Journal of Medical Ethics.

Older people, including those with early stage dementia, often continue to enjoy a in their own homes, but once they move into residential care, lawful and consensual sexual expression is frequently frowned upon, argue the authors from the Australian Centre for Evidence Based Aged Care.

Lack of privacy, safety fears, concerns about duty of care, anxieties about potential repercussions from relatives, and ageism all get in the way of what is "a basic human right" and "a normal and healthy part of ageing", they say.

"Since it has been well established that sexuality and intimacy continue to be important in later life and are central to an individual's health and wellbeing, the lack of attention paid by to residents' sexual needs is concerning," they write.

And the existing research indicates that residents do want their sexual expression to be acknowledged and believe that healthcare professionals should ask them about their sexual needs, they say.

But many residential facilities lack formal policies or guidelines or appropriately trained staff to address this, they contend. And they are not helped by existing frameworks for assessing mental capacity and consent, which apply primarily to high stake decisions, such as treatment and power of attorney.

There are some frameworks to assess decision making capacity around sex, say the authors, but they are unsuitable. A person may perform badly on a mini mental state test (used to assess ), but is often still able to express a preference for a friend or lover.

The authors acknowledge that it is important to protect the vulnerable from harm and to ensure that is not harmful, abusive or illegal, but that should not prevent people with dementia from making their own decisions about sex, they argue.

They may indeed be exposed to emotional distress if a relationship ends, they write. "However, these are risks that any sexually active person faces throughout his or her life, and we should not confuse a bad or unwise decision with incompetence."

They add: "Seeking to 'protect' individuals with dementia by not allowing them to express their sexual needs, thereby stifling their autonomy and personhood, is a far greater failure of duty of care. It is also, we would argue, a violation of the fundamental right of a person with dementia to be recognised as a person before the law."

These issues are likely to become more relevant and pressing as the population ages and more and more residential care homes will be needed, say the authors.

"At present, rather than engaging with the delicate balancing act between resident autonomy and duty of care [ homes] are choosing to ignore the issues and tread on the side of caution." they conclude.

Explore further: Multidisciplinary integrated care for seniors gives better quality care

More information: doi: 10.1136/medethics-2011-100453

Related Stories

Multidisciplinary integrated care for seniors gives better quality care

June 27, 2011
Multidisciplinary integrated care of seniors in residential care facilities resulted in better quality of care, found a Dutch study published in CMAJ (Canadian Medical Association Journal).

Older women lack important information about sexual health

September 14, 2011
Many women over 50 years old date and are sexually active and thereby face many possible health risks. Yet, most educational campaigns designed to prevent sexually transmitted diseases target younger generations. Older women ...

Caregivers and their relatives disagree about care given, received

August 1, 2011
Caregivers and their relatives who suffer from mild to moderate dementia often have different perceptions regarding the amount and quality of care given and received. A study by researchers at Penn State and the Benjamin ...

Recommended for you

'Man flu' may be real

December 11, 2017
The much-debated phenomenon of "man flu" may have some basis in fact, suggests an article published in the Christmas issue of The BMJ.

Full moon linked to increased risk of fatal motorcycle crashes

December 11, 2017
The full moon is associated with an increased risk of fatal motorcycle crashes in the United States, the United Kingdom, Canada and Australia, finds a study in the Christmas issue of The BMJ.

Social media trends can predict tipping points in vaccine scares

December 11, 2017
Analyzing trends on Twitter and Google can help predict vaccine scares that can lead to disease outbreaks, according to a study from the University of Waterloo.

Study suggests being proud may protect against falls in older people

December 11, 2017
Contrary to the old saying "pride comes before a fall", the opposite appears to be true, according to a study published in the Christmas issue of The BMJ.

Peppa Pig may encourage inappropriate use of primary care services

December 11, 2017
Exposure to the children's television series Peppa Pig may be contributing to unrealistic expectations of primary care and encouraging inappropriate use of services, suggests a doctor in the Christmas issue of The BMJ.

Women's sexual orientation linked to (un)happiness about birth

December 11, 2017
Unhappiness about a pregnancy or birth has been associated with negative health outcomes for mothers and babies. Yet, unhappiness about a pregnancy or birth has been understudied, particularly among sexual minority (non-heterosexual) ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.