Nursing Home Sex

What You Need to Know About Sex in Nursing Homes


Last updated: December 09, 2008
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The sexual life of our elders is something we younger folks shudder to imagine (and I confess to being guilty) -- whether it's an aversion to thinking about what goes on behind a parent's closed bedroom door, or horror at the notion of Viagra in the medicine cabinet.

This willed ignorance about the sexuality of those who, somehow or other, managed to beget us, continues all the way to the nursing home, it turns out -- sometimes with heart-rending consequences.

A recent study by a team from Kansas State University includes a subtle, yet poignant, example. A married couple had moved into a nursing home room with adjacent hospital beds. One spouse had a condition that required him to elevate a leg, and the beds had been placed so that the leg was on the same side as his spouse, which made it hard for them to hold hands. Staff members didn't see this as a problem, and told the couple, essentially, to live with it.

Slate offers an even more extreme example. Bob and Dorothy, both of whom suffered from dementia, fell in love in an assisted living facility. When Bob's son walked in on his 95-year-old father in flagrante dilicto, he demanded staff separate the two, and ultimately moved his father to another facility. Heartbreak ensued, as did the rapid physical and psychological decline of the graying Romeo and Juliet.

Why all the suffering? Because Bob's son couldn't bear to think about it.

While we're not thinking about it, our elders apparently are. A study in the New England Journal of Medicine found that the majority of those 75-85 years old -- about 53 percent -- are in fact sexually active.

The Kansas State researchers observed impediments to physical intimacy in nursing homes as basic as shared rooms with only a flimsy curtain for privacy. But the biggest obstacle was simply that staff, like the rest of us, weren't prepared to acknowledge sexuality among the elderly.

The most common reason offered for restrictions on sex in nursing homes is the conundrum of Alzheimer's and dementia. Are those afflicted able to offer genuine consent? Who decides?

We squeamish kids -- although we may have legal decision-making power in some cases -- are arguably the last ones who ought to be making decisions when it comes to the sex lives of our parents (remember how we felt as teenagers when they tried to butt into ours?). The Kansas State researchers are advocating for federal guidelines, and some elder advocates are now recommending that part of getting one's papers in order should include a sexual power of attorney.

This seems like a pretty good idea to me, although frankly, I think I'd make a lousy candidate for the job of sexual trustee. Were my own divorced parents to move to retirement communities and luck into late-in-life romance, I imagine I'd be thrilled for them. But that's about as far as my imagination is willing to take me. If dementia entered the picture, and a sticky situation were to arise….well, I'd be more than happy to pull the curtain, and leave the decision-making to, say, a duly deputized second cousin.

But that's not going to happen if I can't even bring myself to broach the subject in the first place.

Certainly, when the time comes for our parents to move into a nursing home or assisted living community, the list of things to talk about -- money, location, what to do about the house -- is long enough as it is. But if we're going to treat our parents the way we wanted to be treated as, say, sexually nascent adolescents -- as full human beings with needs and desires, capable of making choices and forming deep connections -- it may be time to think about having "The Talk."

Again.

Image by Flickr user Atmantis used under the Creative Commons attribution license.

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9 Comments So Far. Add Your Wisdom.

over 2 years ago

What a great article !!! Of course we do not see our parents as sexualy active - what do the kids think how they got here ? Touchy subject sure, but one that does have to be faced and dealt with.


over 2 years ago

I'm so glad this subject is being boached! I think families should butt out and let nature run its course. Who are we to say what the suffering seniors can and cannot do in this area. Fulfilling a natural, God given gift can only be helpful for both husband and wife. If they are physically able, within the confines of marriage, why not?


almost 3 years ago

95? cool he should get a metal, cake and around of applause! lol


almost 3 years ago

I love this article! It addresses a difficult subject head on! My parents are now 90 years old, and up until 5 years ago were extremely sexually active (every night Josephine). Of course for quite a while Viagra was the assistant for my Father. My siblings are extremely squeamish about this subject, but since my Father had been speaking to my husband for quite a long time about these things (which of course he passed on to me), I guess I was used to it. After all, it is mostly likely that our own sexual habits were passed on to us from our parents. A very large decline in my parents cognitive reasoning happened starting at the time that my Mother had a vaginal prolapse (result of poor pelvic floor muscle tone - keep up those Kegels and do Pilates ladies!). The pessary the Dr. gave her failed to help, and for some reason, their Dr. obviously thought it was unimportant enough to have surgery. If I had been involved in her health care at the time, I would have insisted on her having the A&P repair to allow their sexuality to continue. Both of them have declined into dementia, and have other problems, and they live in Assisted Living, because it was most important to them that they be able to be together until the end. Who knows when that will be, but I sure wish they still had the ability to do what they both obviously loved (great cardio exercise for them as well). My advice is - get over your squeamishness and make sure that your parents wishes are honored until they dementia progresses too far. After all, it's their lives and their bodies that matter, not ours.


about 3 years ago

That you can be so compassionate and understanding of the needs of the elderly.


over 5 years ago

Poet522- I failed to mention that I am a 40 year old research chemist who has done a lot of drug study work in human clinical trials for the FDA. I know what I am talking about. Please see the following "HIV/AIDS among Persons Aged 50 and Older" located on the CDC's website. I trust that you will not condescend the CDC. Likewise, please forgive my seeming hostility. But misinformation that encourages others down a path that is harmful to them, their parent(s), or grandparent(s) must be confronted.


over 5 years ago

Poet522- A wise person learns the value between a healthy balance of quantity and quality of life. AIDS is a painful and humiliating disease. It is evident that you have no medical expertise nor a true caring of quality of life. While you are correct that the 'greater issue" is the SURVIVAL and recognition of HEALTHY and vibrant-- try relationships here instead of your errant choice of sexuality-- among our parents and grandparents...unsafe sex and contracting HIV, experiencing full-blown AIDS is fulfiling of neither survival nor healthy relationship. Again-another person who has their thinking cap not tied tightly enough. Next time read your post and check your logic.


over 5 years ago

Thanks for a useful, thoughtful post that goes where most of us do not dare. While HIV/AIDS is an issue that elders (like the rest of us) must be aware of, the greater issue is the survival and recognition of healthy, vibrant sexuality among our parents and grandparents.


over 5 years ago

Unfortunately the major concern over sex amongst the elderly in nursing homes was not addressed...HIV/AIDS. The population with one of the fastest growing rate of HIV contraction is among seniors in nursing homes. It may be uncomfortable to realize one's parent(s) or grandparent(s) are sexually active, imagine the feeling with learning they have contracted HIV and will die of AIDS. Really am tired of people who are superficial in their knowledge of a topic. To the writer: I'm not impressed ... please learn to be thorough in your research...otherwise you merely sound like an idiot on top of giving people poor information.


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