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True or False:
Staff are likely to respond differently to residents of differing genders, with a protective stance likely towards women.
For many staff the main source of tension regarding sexuality is the conflict between the need to protect people who lack capacity to consent to sexual activity while allowing autonomy of residents who do have capacity. Staff are likely to respond differently to residents of differing genders, with a protective stance likely towards women. There may also be “protection” issues for the the care home.
Being constantly involved with many intimate aspects of others’ daily lives, staff is not always as aware as they should be of the need of older people for privacy. Like many young people, they can operate as though they believe that:
Being constantly involved with many intimate aspects of others’ daily lives, staff is not always as aware as they should be of the need of older people for privacy. Like many young people, they can operate as though they believe that their generation discovered sex—or in any case, that it is for the young and fit, and not for the old, especially older people with dementia. Worse, they can view sexual interest as deviancy.
One of the challenges that can cause most concern for care staff, families, and friends is when a new relationship begins in a care home. This may involve:
One of the challenges that can cause most concern for care staff, families, and friends is when a new relationship begins in a care home. This may involve one resident with dementia and one without, or two residents with differing degrees of dementia. Added to this complexity, the resident with dementia may already have a partner who does not live in the care home.
True or False:
People with dementia are capable of forming new intimate relationships, and as long as they are able to make decisions about their life, their decisions should be respected.
It is perhaps all too easy to assume people with dementia are not capable of forming new intimate relationships; however, as long as the person with dementia is able to make decisions about their life, then their decisions should be respected. Matters become more complicated, however, when one or both of the residents with dementia may not have the mental capacity to consent to sexual relations.
As residents with dementia are open to abuse, it is essential to consider issues such as:
(Mark all that are correct)
Matters become more complicated when one or both of the residents with dementia may not have the mental capacity to consent to sexual relations. As residents with dementia are open to abuse, it is essential to consider issues such as whether the resident with dementia recognizes the person they are having the relationship with, whether they can express their views and wishes within the relationship, or how they will be affected by rejection.
“Proactive protection” involves:
(Mark all that are correct)
Proactive Protection: In dealing with sexual behavior among residents many staff stand guard and disregard residents’ sexual needs. A more mindful attitude is an attitude of “proactive protection” in which staff education and support gives residents choice and social stimulation and facilitates independence and dignity.
Issues or problems with abuse protection can include:
Protection can be an important issue as some residents are vulnerable to the intrusive sexual behaviors of others which can be problematic during the night when homes have low staffing levels. For many staff the main source of tension regarding sexuality is the conflict between the need to protect people who lack capacity to consent to sexual activity while allowing autonomy of residents who do have capacity. There may also be “protection” issues for the the care home: providers may be concerned about liability should residents be inadequately protected by staff from unwelcome or coercive sexual approaches.
True or False:
Regular assessment and attention to boredom, loneliness, and need for touch can reduce sexual acting out.
Regular assessment and attention to boredom, loneliness, and need for touch can reduce sexual acting out. The need for touch can be addressed by massage, dance, or other less sexually explicit physical activities. Masturbation may reduce sexual behaviors that involve other people.
Strategies for sexual and sensual expression include:
Strategies for sexual and sensual expression: Develop policies on practices and procedures relating to sexual expression. Promote staff awareness and recognition of coercive or unsafe sexual behavior. Think about older people’s sexuality as a routine part of life. Watch for cues regarding needs for intimacy or sexuality to help support these needs as appropriate. Such actions reflect unmet need; help people to address this in an appropriate way. Assist sexual expression by providing privacy, appropriate furnishings, and permitting overnight stays. Guarantee an environment conducive to sexual expression.
Which is not one of the 10 Key Points of the “Last Taboo” guide for care staff?
The guide for care staff is summarized in 10 key points: 1. Some residents with dementia will have sexual or sensual needs. 2. Affection and intimacy contribute to overall health and well-being for residents. 3. Some residents with dementia will have the capacity to make decisions about their needs. 4. If an individual in care is not competent to decide, the home has a duty of care towards the individual to ensure they are protected from harm. 5. There are no hard and fast rules. Assess each situation on an individual basis. 6. Remember not everyone with dementia is heterosexual. 7. Inappropriate sexual behavior is not particularly common in dementia. 8. Confront your own attitudes and behavior towards older people and sex generally. 9. Communicate – look at how you can improve communication with your colleagues, managers, residents, and carers on this subject. 10. Look after yourself and remember your own needs as a care professional.
