Despite the many health-related problems that might interfere with a healthy sex life, the majority of older adults remain engaged in sexual activity and view it as an important aspect in their lives. Some individuals may not be completely comfortable talking about sexuality and aging and still others may forget about or ignore it altogether when the older adults are cognitively impaired due to a dementia-related illness.
Benefits of Remaining Sexually Active Later in Life
In general, older adults who are more physically active also tend to be more sexually active. Sexual activity and intimacy are shown in research to be associated with increased well-being and life satisfaction. Some studies suggest that sex can decrease pain, improve cognition and quality of sleep. Sexual activity releases brain chemicals that make people feel happy, reduces stress, and strengthens the immune system. Despite these benefits, and many others, sexuality is ignored when caring for older adults.
Sexual Activity in Skilled Nursing Centers
The topic of sexual activity and expression among older adults and seniors who have some type of dementia and live in a skilled nursing center is difficult for many people to approach. It makes some healthcare professionals feel uncomfortable and family members concerned or worried. There are those, of course, who do not have any issue with sexuality and dementia and believe it is a basic right that should be honored in sensitive and appropriate ways.
Person-Centered Approach
Most senior care communities now indicate that they believe in and offer person-centered care and services. If this is true, there must be permission granted that allows individuals with a dementing illness to express themselves sexually. Safe spaces, as much consent as possible and developing policies are important aspects of delivering this level of person-centered treatment.
Some Challenges
There will always be challenges to allowing sexual activity to occur within skilled nursing or any other senior care community. The rights of those diagnosed with dementia as well as seniors who are more cognitively alert must be protected. Staff can develop the mindset that sexuality occurs across the life span and just because a neurodegenerative disorder is diagnosed doesn’t mean the end of sex. Some staff will not feel comfortable talking about sex with their residents, and they should not be pushed into doing so. Direct care staff may be best suited to discuss their resident’s thoughts and feelings, after all, they provide 90% of the hands-on and more intimate care to begin with. Ignoring the senior’s sexuality can have a negative impact on well-being and quality of life.
Don’t They Have Rights?
While most care communities post their Resident Bill of Rights in public places where everyone can see the document, it doesn’t include the right to sexual expression. Since it doesn’t address this important area, each care community can develop their own policies and procedures concerning sexual expression and include cognitive impairment as a part of it. Some rights may include having privacy and private space, professional counseling on sexuality and aging, the right to engage in consensual acts, and to have materials of their choosing. The Hebrew Home in Riverdale, New York has created such a policy and they report that it’s going well.
Take Away
Everyone is aging. No one knows what types of health or cognitive problems will develop in the future. If sexuality is important at younger ages, most likely it will remain important as individuals age. Just because someone develops Alzheimer’s disease, Lewy Body disease, Parkinson’s or Huntington’s doesn’t mean that sexuality is completely lost for good. Quite the opposite.