Sexuality Among Institutionalized Elderly Patients with Dementia

Abstract

The subject of sexuality among elderly patients with dementia was examined, focusing on two main aspects: the sexual behaviour of institutionalized elderly people with dementia; and the reactions of other patients, staff and family members to this behaviour. The behaviour was found to be mostly heterosexual and ranged from love and caring to romance and outright eroticism. Reactions varied, being accepting of love and care but often objecting to erotic behaviour. Understanding of the sexual needs of elderly people should become an integral part of the training and continued education of health care staff, thus helping to resolve conflicts and clarify common misconceptions.

Catering to Love, Sex and Intimacy in Residential Aged Care: What Information is Provided to Consumers?

“…While it may be argued that such an extrapolation is risky, this apparent neglect of institutionalized older adults' sexuality is consistent with Australian and overseas studies [26,27,[35][36][37][38][39] which strongly support the view that it may be difficult for institutional staff and residents' families to accept older people's sexuality as normal and of potential importance [28,38]. The absence of published guidelines and policies to inform practice in this area, reinforces our view that responses to sexuality are often ad hoc and driven by personal values and attitudes.…”

Older residents’ perspectives on aged sexuality in institutionalized elderly care: A systematic literature review

“…One study explicitly sought for older gay participants (Stein et al, 2010). While some of the studies limited their study population to older people with a diagnosis of dementia (Ehrenfeld et al, 1999;Tzeng et others were rather vague about the required cognitive abilities of participants, only sought for cognitively intact residents or included both residents with and without dementia. Most studies including residents with dementia used an observational design and thus reported on the intimate and sexual behavior of these residents rather than offering an insight in the residents' own perspectives on aged sexuality (Ehrenfeld et al, 1999;Hubbard et al, 2003;Tzeng et al, 2009;Ward et al, 2005;Zeiss et al, 1996).…”

“…According to Ehrenfeld et al (1999), most sexually-based interactions between residents with dementia are initiated by male residents and directed toward a person of the opposite sex. Sexual expression in older residents with dementia, however, might also entail sexual behavior toward same-sex residents, staff and visitors, solitary sexual activity and verbal sexual behavior (Ehrenfeld et al, 1999;Tzeng et al, 2009). Ehrenfeld et al (1999) identified three categories of sexual behavior expressed by residents with dementia.…”

Sexuality in Residential Aged Care: A Survey of Perceptions and Policies in Australian Nursing Homes

“…Within residential aged care facilities (RACFs), a broad spectrum of sexual expression has been noted for older people both with and without dementia including 'loving and caring', 'cuddling', 'intimate touching' and 'aggressive eroticism' [3,8,9]. While some research reports moderately positive and permissive attitudes towards later life sexuality held by aged care staff (10), other research suggests that many RACF staff lack tolerance of or hold negative or patronizing attitudes towards the sexual expression of residents [11], and that 'inappropriate' sexual behavior, particularly among those with dementia, is often a source of difficulty [12,13].…”

“…The desire for sexual intimacy often remains important well into old age [1,2], despite the presence of functional disability, including dementia [3][4][5].…”