The (old) age of consent
Let’s talk about sex … for elderly people in care
THE ability of older Australians to enjoy intimacy and express sexuality is often compromised – or controlled – when they move into residential aged care.
That’s the finding of a study by Linda McAuliffe and Deirdre Fetherstonhaugh from La Trobe University’s Australian Centre for Evidence Based Aged Care, who sent surveys to about 3000 aged-care facilities.
They asked staff what influenced their decision-making about residents’ intimate relationships and sexual expression.
The researchers say that while sex and older people remained a taboo topic for many, older people wanted to talk about it and would like health professionals to at least ask them if they would like to discuss it.
Their study also highlighted that only half of facilities had written policies on sexuality, only one in six had policies on sexual health, and one third on sexual behaviour.
Professor Fetherstonhaugh said the reasons sexual activity might be controlled or compromised varied, but included a lack of privacy, unavailability of shared rooms with double beds, unlockable doors, lack of a partner, or difficulty establishing new or maintaining old relationships.
She said a lack of legal guidance compounded the issue.
“While legislation on mental capacity exists for legal, financial and medical decisions, with explicit criteria for when one’s decisions are to be upheld, this offers little guidance when it comes to older people’s sexual decisions in residential aged care,” Professor Fetherstonhaugh said.
The researchers found the level of cognitive impairment of residents and family disapproval also influenced some staff views.
Dr McAuliffe says older people considering moving into aged care should be informed about how their intimacy needs will be supported.
“At present, older people are expected to permanently move into residential aged care without knowing whether they will be able to share a bed with their partner ever again,” Dr McAuliffe said.
“We know that even when staff attitudes are positive there are a range of barriers in aged care to helping older people enjoy their right to sexual freedom.”
Professor Fetherstonhaugh says sexuality in aged care does pose a challenge for staff.
“This is particularly so when a resident has dementia and there are questions around capacity to consent to intimate behaviour,” she said.
“In such cases, staff negotiate a delicate balance between the resident’s right to sexuality and their professional duty of care.”
Dr McAuliffe added: “We would now also like to speak to people living in the community – potential future residents – about what is important to them … Certainly intimacy needs to be considered in the future design of residential aged-care facilities.”