Late-Life Sexuality Presents Problems, Rewards: Nursing Homes Face Competing Values and Principles Involving Safety, Dignity, and Decision Making

By Brunk, Doug | Clinical Psychiatry News, April 2008 | Go to article overview

Late-Life Sexuality Presents Problems, Rewards: Nursing Homes Face Competing Values and Principles Involving Safety, Dignity, and Decision Making


Brunk, Doug, Clinical Psychiatry News


SALT LAKE CITY -- Most Americans find it difficult to accept late-life sexuality, according to Dr. Andrew S. Rosenzweig.

"Our culture still has this pervasive negative attitude about late-life sexuality in terms of discreet silence, distaste, and tunnel vision," said Dr. Rosenzweig, an assistant clinical professor of psychiatry at Brown University, Providence, R.I.

Nevertheless, sexual desires among residents are normal and should be accepted, he said at the annual symposium of the American Medical Directors Association.

Not only family members of residents, but health professionals also have biases and can be judgmental on the topic, said Rosenzweig, medical director of MedOptions, a company based in Old Saybrook, Conn., that provides behavioral and primary care consulting services to nursing homes and assisted living facilities.

For instance, one Israeli study observed that nursing staff caring for Alzheimer's residents at a nursing home categorized residents' sexual behaviors in three ways: love and care, romance, and eroticism (Nursing Forum 2006;41:158-66).

The nursing staff showed acceptance and support of love and care, mixed reactions to romance, and strong reactions of anger and resentment to erotic behavior. That some staff found romance between residents troublesome and that most were appalled by erotic behavior reflects narrow biases, Dr. Rosenzweig said. "So clearly there's a lot of staff confusion and ignorance, and lack of training about late-life sexuality.... We should not underestimate the need for affection, for touch, for a connection with someone else."

The goal for nursing facility professionals should be to create an environment that will help residents fulfill their sexual needs and desires while maintaining dignity and protecting rights of competent and incompetent residents. Some of the competing principles and values include the right to privacy, the right to experience a loving relationship, and the right to make one's own decision. Beyond that, however, staff members need to refrain from being judgmental. "It's very easy to project one's own religious, cultural, and personal beliefs on another," Dr. Rosenzweig said.

Sexually inappropriate behavior may include genital exposure, masturbating in public, propositions to others for sexual intercourse, fondling another resident's genitals or breasts, requesting unnecessary genital care from staff, touching a caregiver in a sexually suggestive manner, and openly reading pornographic material. Sexually provocative but less problematic behaviors in nursing home and assisted living settings may include flirting, excessive flattery, commenting on a caregiver's behavior or appearance, and asking staff members personal questions.

The prevalence of sexual-behavior reports among dementia patients in nursing homes ranges from 3%-15% of reports of inappropriate behaviors, "but there have been very few studies," Dr. Rosenzweig said. However, some evidence has linked those behaviors to frontal and temporal lobe pathology, especially disinhibited types of behaviors, he said. Acute onset of sexually inappropriate behaviors may follow stroke, vascular insult, and head injury. Differential diagnosis includes delirium, mania, seizure disorder, dopaminergic drugs, social isolation, and boredom.

Dr. Rosenzweig urged those attending the meeting to consider the barriers that nursing facilities residents face in making intimate human connections.

"Imagine your typical nursing home or assisted living facility, where the amount of privacy is zero and opportunities for expressing sexual desires are zero," he said. "The literature on geriatric sexuality is showing that even with all these obstacles, there is a high amount of sexual desire in our residents, regardless of medical or psychosocial comorbidities. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Late-Life Sexuality Presents Problems, Rewards: Nursing Homes Face Competing Values and Principles Involving Safety, Dignity, and Decision Making
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.