Sexuality In the Nursing Home
Sexuality is part of human nature throughout life. It doesn't automatically stop at the nursing home door. Being elderly and sick does not necessarily mean sexual desires decline. Family members and nursing home staff should expect sexual behaviors to occur and they should be ready and willing to respond appropriately.
Reasons Residents May Show Sexual Interest In Others
- Residents need to maintain intimate relationships.
Intimate relationships are important to life satisfaction and physical health. Residents of nursing homes have suffered multiple losses. They have lost their homes, their health, their independence and, usually, their life partners. An intimate relationship is something a resident can still maintain and treasure.
Humans thrive on being needed and accepted by others. Touch shows acceptance and positive regard. Touch deprivation results in depression, unresponsiveness and even death
Physical or mental illnesses AND medications can affect sexual interests.
Some diseases or medications can decrease sexual behaviors and some can increase sexual behaviors.
- Transference may cause sexual interest in another.
By their mannerisms or looks, a person may remind a resident of someone significant in their life. If the significance of this person in their life (especially if it is a deceased partner) involved sexual intimacy, the resident may transfer this love and want for intimacy to another. The focus of this transference may be a staff member or another resident.
Inappropriate sexual behavior may be a part of a resident's personality.
Inappropriate behaviors don't just go away once a resident is admitted to a nursing home. Nursing home staff need to obtain behavioral history on the resident so they can respond appropriately.
- Inappropriate sexual behaviors may be "acting out" behaviors.
Unwanted advances may be expressions of anger or frustration concerning the resident's health and living conditions. The behaviors may be a residents way of attracting attention.
How To Respond Appropriately To Inappropriate Behavior
- Realize that it could happen to anyone.
Try not to be taken by surprise or to express negative emotions. Look for indicators of tendencies toward sexually inappropriate behavior, e.g. jokes with sexual innuendos. Sexual advances may be cross-sex, same sex or both. Before providing care, identify who you are and what you are going to do. Be sure your touch is appropriate.
Through regular in-service training, staff should be educated about and prepared be handle sexually inappropriate behaviors. Nursing facilities should enact policies and procedures for identifying and dealing with unwanted and inappropriate sexual behavior that may occur between residents and also staff.
- Do not negatively label or punish the resident.
Firmly but gently identify unwanted behavior and point out that it is unacceptable. Remind the resident who you are, especially if the resident is confused. Don't make the resident feel ashamed over a mistaken identity or something s/he can't control. Discuss the incident with appropriate staff but remember to keep it confidential. Remain as objective as possible and do not make moral judgements.
- Try re-labeling the behavior.
Re-labeling can diffuse the situation by bringing an emotionally charged situation into focus. Also, remember that sexual interest shown by a resident may very well be a sign of health and recovery. What must be determined is whether the behavior is healthy for that individual.
- Try to re-direct the behavior.
If the behavior is inappropriate, give the resident something else to be do with his/her hands. An alert resident may realize this tactic so you will also need to attempt to redirect his/her thoughts. If masturbation in public is a problem, staff should be trained to recognize the resident's behavior and move the resident to a private area when the behavior occurs.
- Don't encourage unwanted behaviors.
Don't encourage inappropriate jokes by responding to them or telling them. Don't use suggestive or inappropriate language. Don't dress suggestively. Don't respond to inappropriate and unwanted behavior with positive reinforcement. Respect residents' privacy. Do not interrupt masturbation or sex by consenting and alert residents when they are in a private location.
- Do not be afraid to ask for help.
If you are a resident, tell your charge nurse. You are a staff person, tell your supervisor. You are not at fault or "bad" because a resident expresses sexual interest in you. As a resident, the nursing home is obligated to protect your health and safety. If you are a staff person and the situation affects your ability to comfortably work with the resident, you may need to be re-assigned. It may be necessary for staff to care for the resident in pairs.
- Do not just ignore the problem.
If you ignore it, the problem will get worse. Family and staff should address inappropriate behavior during the care plan meeting. Positive family involvement should be encouraged.
- The resident's needs may not be sexual.
The resident may need more positive, appropriate physical contact from staff and family members, e.g. pats on the back, hugs. Staff and family should make attempts to make positive comments about the resident's appearance. Everybody wants to look good and everybody needs to be loved.
Remember, facilities must provide at least one place for private visitation during normal visiting hours. This place must be provided in addition to the residents' room.
For more information please contact the Atlanta Legal Aid Society or Georgia Legal Services Program office nearest you.
For Clayton, Cobb, Dekalb, Fulton, and Gwinnett Counties, call Atlanta Legal Aid Society: 404-524-5811
For all other counties, call Georgia Legal Services Program: 1-800-498-9469 (toll free)
For Seniors age 60 and older, call the Georgia Senior Legal Hotline: 1-888-257-9519 (toll free)
Atlanta Legal Aid Society
Last Revised: May 2003