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Ask the Expert: Sex in the Nursing Home? - Aging Wisely

All month leading up to our The Age of Love movie screening, we have been exploring issues such as companionship and intimacy as we age, how to know when an aging parent’s relationship might be exploitative, and how we stereotype, isolate or diminish older adults’ need for intimacy and sexuality. Today, we tackle the topic of sex in the nursing home…how care facilities handle residents’ sexual needs while protecting the needs of all residents, resources for families when this issue arises, and more.

Mease Manor Dunedin

Luanne Reese

We’re pleased to have an expert guest with many years experience in retirement community management from our movie screening co-host, Mease Manor. Mease Manor is a retirement community in beautiful Dunedin, Florida which offers a continuum of care options on one campus (from independent living to assisted living and healthcare services). Luanne Reese is the Chief Strategy Officer at Mease Manor, where she has worked since 2007. We asked Luanne to share her knowledge and experience with our readers and answer our questions about sexuality in retirement communities and nursing homes.


Q: Some people have talked about the lack of privacy in nursing homes and how this relates to seniors’ sexuality. How can we balance the need for safety/supervision in a group setting with the reality that older adults do continue to be sexual human beings with a need for intimacy?

A: Issues can arise very easily around privacy.  We need to first make sure that both parties are competent to offer consent to the relationship.  We need to make settings available for this time to occur between consenting individuals.  Also, consultation with the resident’s physician about any limitation must be considered.  Many times the intimacy may be something as simply lying next to each other in a bed.   ​​

Q: Do care facilities have formalized policies related to residents’ sexuality and/or resident rights on these issues?​

A: Each community would have individual policies and states could have rules and regulations that would vary (Nursing homes and other health facilities are regulated by each state. AHCA is the Agency for Healthcare Administration, which manages this process in Florida. You can visit the AHCA website here. Our care management team can help you understand policies, residents’ rights and what to ask when considering a care community.).  It is important to talk with staff to find out what is specific to each community.  ​

Q: Do issues arise with staff who may have personal, cultural or religious beliefs that relate to the residents’ sexual behavior (for example, disagreeing with a resident who is engaging in consensual sex while still married to a spouse not living at the facility or residents engaged in same-sex relationships)? ​

A: Personal or religious beliefs come into play a great deal with staff, however, those are personal beliefs and cannot be forced upon others.  Many other examples such as end-of-life care or refusal of medical treatments are dealt with in senior housing communities.  Staff has to keep personal beliefs as personal beliefs.  However, a balance has to be struck in the protection and feelings of other residents who have residents’ rights as well.  Discrimination cannot be tolerated in respect to the LGBT (Lesbian, Gay, Bisexual, and Transgender) community.

Q: How do you handle staff training or coaching on resident sexuality issues?

A: This would be addressed inside of residents’ rights discussion and most likely brought up on case by case basis.

Q: Often one of the trickiest aspects of these situations is the family members and their perceptions. ​How do you handle family members’ concerns?

A: Again, as long as the person has been deemed competent and fully understands their actions, that is where the conversation has to begin.  I think this an opportunity for all of us as senior living providers to offer support and education for the residents and their family members.  Just like your high school children do not want to have “that” conversation with mom or dad, children may have great trepidation about having “that” conversation with their parents.  There are resources that we need to make available.  ​

Q: Adult children may not wish to see their elder parent as a sexual being and/or may feel protective or angry seeing a widowed parent engage in a new relationship. How do you engage family members about these issues and what are your related policies?​

A: Feeling protective is a natural feeling; this again may be an opportunity to offer resources such as grief counseling or other support groups.  Each community is different and, over time, we may encounter different concerns that we’ll need to address. We have generally not seen this issue arising regarding intimacy​ with blended families.

Q: What advice or information would you give to family members?​  ​

A: I would tell people to reach out to the administrator or the social workers inside of the nursing home.  If it is in an Independent Living or Assisted Living, reach out to the administration as well.  Communication is important to make sure that people understand that you are just looking out for their safety and well being.

Q: What problems arise with sexual issues in persons with dementia?​

A: Sometimes within the symptoms of dementia and Alzheimer’s the sexual issues become much more difficult to handle.  Again, making sure someone is competent to make a decision and that a doctor feels they can make the decision is important.  Some of the acting out with advanced stages of the disease takes on a decidedly sexual overtone.  It is important for families to lean on the staff, because more than likely they have seen this before. Resources like the Alzheimer’s Association can help as well.  Sometimes this is also just that need for a simple hug. The need for companionship and touch is important throughout life.

Join us at Mease Manor for The Age of Love screening on February 27th.

Contact Aging Wisely at 727-447-5845 for help with your aging parent concerns or questions. Our expert team provides caregiver consultations, assessments, care planning and advocacy with care facilities and much more. We help you tackle the tough issues!

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