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Aged care residents have the right to access safe and high-quality care and services. But what happens if a resident wants to engage in intimacy and should aged care staff interfere?
If you live with dementia or have a loved one that does, we are here to help. Call us any time on 1800 100 500. We are available 24 hours a day, seven days a week, 365 days a year.
Are residents able to engage in intimate relationships in aged care?
Aged care facilities are required to comply with the Aged Care Quality Standards. Standard One is considered to be central to meeting all standards and has a consumer statement that says:
I have control over and make choices about my care, and personal and social life, including where the choices involve personal risk.
The guidelines go on to say:
Each consumer is supported to exercise choice and independence, including to: make connections with others and maintain relationships of choice, including intimate relationships.
Aside from legislation and policy considerations, there are also complicated philosophical considerations regarding person-centred care. For example, are aged care workers required to support who the person was before diagnosis, such as someone who has lived a life of celibacy or a person who demonstrates a strong desire to explore their sexuality?
Ultimately, aged care residents maintain the same rights to sexual expression, intimacy and privacy as any other adult in our society. A diagnosis of cognitive impairment does not automatically erase these rights.
Are there risks associated with people living with dementia engaging in consensual sexual activity?
It is common for family members or health and aged care workers to have concerns about people living with dementia engaging in sexual activity.
Sometimes their concerns are regarding the risk of sexually transmitted diseases or concerns about exploitation. These risks exist for any person engaging in sexual activity so, if the person living with dementia has the capacity to understand these risks and consents, there is no reason to interfere. For more information about consent please read our article: How do you navigate intimacy with dementia?
What happens if a person living with dementia wants to start a new relationship in care?
People with dementia continue to need loving, safe relationships. Dementia can affect a person’s interest, ability and needs in intimate relationships. They may also experience changes in the expression of their sexuality. Some people continue to desire sexual contact while others may lose interest.
Relationships between consenting adults can be positive and comforting for people living with dementia. If both partners have capacity and willingly consent to the relationship, aged care staff should respect their decision.
It is important to remember that dementia is a progressive condition and capacity to consent may change over time or even from day to day. The aged care facility must regularly review the capacity of partners to ensure they are able to consent.
What if that person is already in a relationship?
Sometimes a person living with dementia forms a relationship with another resident despite already being in a relationship. This can happen for a variety of reasons including the person missing the affections of their partner or mistake the other resident for their current partner.
This experience can be a challenging time for partners and families, especially if the couple has had a happy life together before the person living with dementia entered residential care. There can be a deep sense of loss and hurt when this situation arises.
It can be beneficial for partners in this situation to attempt to see the situation from the point of view of the person living with dementia. People living with dementia live in the moment and can make close connections with another person in that moment. The person living with dementia may be seeking comfort and security. Forming a close, possibly intimate, relationship with another resident is an attempt to meet these needs.
Partners can find a gamut of emotions arise and may want to stop the relationship. However, ending the relationship could possibly have a detrimental effect on the person with dementia’s wellbeing.
Partners can attempt to let go of relationship expectations with the person living with dementia and seek to find emotional support from family, friends or professionals to ensure their needs are met. If you are experiencing this situation and need someone to talk to, we are here to help. Call us anytime on 1800 100 500.
What if one person in the relationship can’t or did not consent?
If you believe a person in the relationship can’t consent this should be raised with the aged care facility immediately.
If the person in the relationship did not consent to an activity that has taken place this should be raised with the aged care facility and the police immediately.
If you are not satisfied with the response by the aged care facility you can make a complaint to the Aged Care Quality and Safety Commission.
How do you manage inappropriate sexual behaviours?
Some people may display inappropriate sexual behaviours as a result of dementia. It is important to remember that any unusual or uncharacteristic behaviour is likely to be caused by the condition, and they may no longer know what to do with sexual desire or how to appropriately exercise the desire.
It is important to consider all the possible reasons for the inappropriate behaviours. This could include needing to go to the toilet, discomfort or boredom. You can also find ways to include different forms of touch in the everyday routine so that the person gets some physical contact. Massage and holding hands are ways of continuing to provide loving touch.
If you live with dementia or are in a relationship with a person that does, we are here to help. Call us any time on 1800 100 500. We are available 24 hours a day, seven days a week, 365 days a year.
If you are an aged care worker and would like to access training on this topic, or many others, visit our Centre for Dementia Learning website: https://dementialearning.org.au/
Want to know more about dementia and relationships? Check out these articles:
How do you navigate intimacy with dementia? How does dementia impact a person’s ability and desire for intimacy? Can people with dementia give consent? In this article we explore these topics and provide practical advice for couples.
Does dementia impact your libido? When Phil was diagnosed with dementia, he knew things would change but one symptom he didn’t expect was his lack of interest in intimacy.
Should I stay or should I go? When Vicki’s new husband Michael was diagnosed with dementia, she quickly realised their life together was not going to be the one she had dreamed of.
Partner, carer or both? We talked to people living with dementia, their partners and a Dementia Australia counsellor to find out if you can still maintain your partnership after a diagnosis of dementia.
For more resources about relationships, intimacy and dementia visit our library guide here: https://dementia-org.libguides.com/relationships-intimacy-and-dementia
Want to read more stories like this one? Subscribe to Dementia Australia’s eNews: https://www.dementia.org.au/newsletters
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