Sex in Nursing Homes: The Debate Continues

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Do senior care and sex make for strange bedfellows? Well, perhaps not. A few months ago, I attended an Alzheimer’s Association conference where one of the seminars dealt with issues surrounding sexuality and dementia. Many of the seminar participants had partners who had been diagnosed with dementia and eventually moved into a facility. A complaint that surfaced numerous times during the discussion was how nursing homes inherently do not allow for privacy: doors don’t lock and rooms are often shared. Moreover, many complained about staff members’ reactions to any acts or displays of intimacy. One woman related that a staff member chastised her for being in bed—fully clothed—and snuggling with her husband when she was visiting him. Repeatedly the point was made that aging did not stop one from being a sexual being, and just how reluctant society is in accepting it!

Sex & Senior Care

So where does the disconnect between sex and senior care start? The crux of the problem is twofold. Most facilities do not train their staff to see residents as sexual beings or to understand that residents might have healthy sexual needs. This issue in someway can be informed by families, who sometimes are the ones paying for care. Adult children seldom see their parents as sexual beings and staff follows suit so as not to upset family members. This leads the management of facilities to conclude that anything even bordering on a progressive stance about sex could result in residents moving out. Exacerbating this problem is that seniors did not grow up in the era of “safe sex” . Many still view pregnancy as the primary concern of sexual intercourse rather than sexually transmitted diseases (STDs). But the senior population could be more prone to infections since many members have a weaker immune system than the general population. And many physicians would not assume a senior was sexually active. Both ageism and age-related changes in the body result in the ability for STDs to be contracted more easily, and go undetected for longer, which could potentially cause more harm.

Luckily, there are exceptions to this rule of trying to stifle the sexual needs of seniors. One that has received a lot of press is the Hebrew Home for the Aged, a skilled nursing facility in the Riverdale section of the Bronx in New York City. Its policy is to allow residents a chance for intimacy, but in a safe environment. If a staff member walks in during a sexual encounter he or she is trained to quickly and politely exit the room. Where the situation gets sticky is when one person has dementia. As I discussed in a previous postings the question of consent is primary in sexual relationships when one person has dementia. At the Hebrew Home for the Aged if staffers see two residents engaged in any intimate act and the couple is not known to be in a relationship then the staff member will ascertain whether it is consensual. Studies about sex and nursing homes have been done since the 1970s, but even with ongoing research, many people are reticent to discuss sex in long-term care facilities. In my opinion it is a matter of respect. Seniors in long-term health care facilities have their lives monitored for their own safety and well-being. Not extending this into the realm of sexuality shows a lack of respect for them as fully developed human beings. It also chips away at the idea that life can remain similar even when one moves from home to a senior care facility. And as for the adult children who have a hard time seeing aging parents as having a sexual side—don’t forget how you got here. I find it nothing short of sad to leave this issue smoldering on the backburner when seniors through intimacy could be leading potentially fuller, more enjoyable lives.

Open your mind,

Lara Belonogoff


The Hebrew Home for the Aged has several different sections to its skilled nursing facility in the Bronx. Read what Gilbert Guide’s experts had to say about this or any other facilities in New York City, along with nationwide facility listings.

about 3 years, said...

I fully agree that intimacy between established couples and new couples is a very important part of life at any age. I also believe the same for those of us that are disabled. many are disenfranchised and expected to just not want intimacy or have sexual thoughts/needs, but they are all as human as we are. Something i have not seen in any of the articles I've read, including this otherwise very well thought out piece, is the rights of those elderly and disabled people cared for in all facilities and/or homes that don't have an available partner to express/enjoy their needs with? Are we dismissing/ignoring/avoiding the even more taboo topic of allowing them to find for themselves, or providing, a sexual service? Something to fulfill the needs of those competent to decide for themselves? With consultation of a small but trained group of carers, doctors, physio's and a sexual surrogate to consider health issues, physical limitations and mental competency many lives could be improved and even issues of unwanted sexual contact/approaches from residents to staff and other residents could be addressed and reduced. Thoughts are welcome :)

about 3 years, said...

I am a social worker in lTC, and have there is a husband and wife there. Separate rooms, the husband keeps asking why he cannot share a room. I bring it up in the morning meeting. I would love to bring an in-service program top my place. Any suggestions.

almost 7 years, said...

Kudos to you, Lara Belonogoff, for initiating a long overdue conversation. Our elderly and diabled have usually lost so much by the time they are in a care facility, how do we continue to deny such an important part of the human condition/experience with such little regard for the emotional and physical benefits of expressed intimacy or, more importantly, the downfalls of being deprived of all it's forms? As the child of a slightly younger, disabled parent in a long term facility, I am absolutely elated that someone, some where had the courage and insight to put the discussion out there. It seems, that in order to navigate the tricky waters & emotionally volatile circumstances of placing a parent, we detach from some of the basic human realities of daily life in a facility...with sex being the proverbial, socio-political 3rd rail of life in long term care. While sex was a difficult enough conversation for most during adolescence, as adults we owe to ourselves and our parents to revisit the topic, if not with them directly, at least with those for whom we've entrusted their care and their rights. While this commentary may seem passionate, harsh even, it comes from a good place, the reality is that all one has to do is imagine today, right now, being denied intimacy with their own partner by their children or those terms it sounds rather odd, doesn't it? If we're lucky, we'll all grow old someday. Our loved one's deserve nothing short of the same rights and respect we'd afford ourselves. After all, long ago, it was that same parent who told me that the most worthwhile conversations were, quite often, the most difficult to have.

about 7 years, said...

Helpful and very interesting.