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Alzheimer's and Intimacy

Alissa Sauer
By Alissa SauerSeptember 14, 2015

While it’s no secret that sexual relationships occur among seniors and even seniors with dementia, the topic still remains extremely taboo. A recent trial brought the subject to national headlines and now caregivers everywhere are faced with the question of consensual sex among aging adults with dementia

When is dementia too far advanced for a person to consent to sex? Learn more about how assisted living communities are handling Alzheimer’s and intimacy while protecting the safety of residents.

The Controversy Surrounding Alzheimer’s and Intimacy

Sexual relationships among seniors living in assisted living communities are not uncommon, so why is there such a struggle when it comes to discussing seniors with dementia having sex?

The controversy was recently in national headlines when a 78-year-old man in Iowa was charged with raping his wife, who was living in a nursing home and has Alzheimer’s disease. The staff in the community maintained that his wife, their patient, was no longer able to consent to sex. He was eventually found not guilty of the crime but the trial did bring national awareness to a topic that often feels taboo.

The question remains how senior living communities are handling this confusing and emotionally driven issue.

At Hebrew Home in New York, the community has a written policy to clarify any confusion over the sex life of residents and has for 20 years. Daniel Reingold, CEO of RiverSpring Health, the nonprofit that runs Hebrew Home, acknowledges the sensitivity of the issue stating, “It was controversial in 1995 and it’s controversial today.”

He went on to say, “We knew that there was intimacy occurring, and we considered it to be a civil right and a legal right. We also felt that intimacy was a good thing, that touch is one of the last pleasures we abandon and lose as we age.”

Sensitivity Surrounds Issue in Senior Living Communities

While the policy at Hebrew Home is a step in the right direction, law professor at Albany Law School and bioethics professor at Albany Medical College, Evelyn Tenenbaum, cautions that even with a written policy, staff may have trouble differentiating between a consensual and non-consensual relationship.

“For example, suppose you have a couple and the woman believes that the man she’s seeing is her husband,” says Tenenbaum. “Then she consents to a sexual relationship. Is that really consent if she doesn’t understand who he is and that she’s not married to him?”

According to the American Health Care Association, there is no clear answer to defining a consensual sexual relationship when one or both partners has dementia.

Patricia Bach, a geriatric psychologist began looking for data to help clarify the question and found that little empirical evidence even existed. When she surveyed members of the American Medical Directors Association, she found that only 25-30% had completed formal training regarding intimacy and sexuality in seniors.

As the aging population grows this issue is going to become increasingly pressing. What do you think about defining consensual sex when one or both partners has dementia? Share your thoughts in the comments below. 

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Alissa Sauer
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Alissa Sauer

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