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Let’s be clear about one thing: not all sexual behavior by seniors is “inappropriate.” Many seniors enjoy healthy sex lives well into older age. A study by the New England Journal of Medicine found 25 percent of seniors over age 75 are having sex, and about 50 percent of those between ages 65 and 75 are also sexually active.
See video: Inappropriate Sexual Behavior
Senior sexuality represents possibly the last remaining taboo. No one wants to talk about it. In a 2013 survey conducted by Home Instead, Inc., fewer than one-third of adult children said they were even the slightest bit comfortable talking to their parents about senior sex.
If a family caregiver asks you for guidance regarding a senior loved one who is fondling himself in public, you might advise them to start with a medical examination. In seniors who can’t communicate well, public masturbation may signal a medical issue, such as pain or a urinary tract infection. These medical causes may be ruled out (or treated) with a physical exam conducted by a skilled geriatric practitioner.
Seniors with dementia may disrobe in public for a variety of reasons. Family members can manage the activity as it occurs. Advise them to always take a shawl or throw with them to cover their family member as the clothes come off. Help your clients find resources for clothing that is difficult to remove, such as items with fasteners in the back. Encourage family members to stay calm and not to shame their loved one. Be sure family members know their loved one cannot necessarily control this behavior.
Sexual inappropriateness with dementia certainly is not limited to men. Women can develop wandering hands, too. One way to cope with wandering hands during embraces is to develop a new way to hug.
How should you respond at the time to behavior of a sexual nature which you consider inappropriate in some way? Try to remain calm, try not to feel embarrassed or show shock. Remember to be respectful to the resident and try to preserve their dignity. Try to reassure other residents or families present that the resident means no harm. Try to remember that the resident with dementia may have no awareness that their behavior is inappropriate or shocking in any way. Depending on the situation, if the behavior is taking place in a communal area, try to distract the resident and lead them away. Jokes, witty replies, and humor can sometimes be used to respond to some forms of sexual behavior. If the resident is touching you in a way you do not like, it is acceptable to identify the behavior and point out that it is unacceptable and you feel uncomfortable. Remind the resident who you are.
What should you consider after the event?
1. What form does the behavior take?
2. What factors may contribute to this?
3. Reflect on how you define and classify inappropriate behavior
4. Consider what risks are involved
5. Looking after yourself
What factors may contribute to this? Could there be a social, environmental, medical or psychological cause? Has there been a change to the resident’s routine or environment? Is it possible that the resident is misinterpreting the actions of, for example, the care worker, or believes them to be someone else they know well or intimately? Have you checked the resident has no underlying medical condition which may be contributing to this behavior? Or that their medication has been changed? Have you assessed the resident’s mental well-being?
As a senior care professional, you have the opportunity to bring senior sexuality out into the open. While adult children report reluctance to talk about this subject, they seem to feel relieved when someone broaches the topic to them.
