Content analysis of public opinion on sexual expression and dementia: Implications for nursing home policy development

Abstract

PurposeWe examined public opinion of sexual expression and dementia to inform nursing home policy and practice.Design and MethodsA content analysis was conducted on public comments (N=1194) posted in response to a New York Times article about a highly publicized legal case involving a husband engaging in sexual acts with his wife who had dementia, living in a nursing home. Researchers utilized constant comparative analysis to code the comments; reliability analysis showed moderately strong agreement at the subcategory level. Data were also coded to indicate whether the commenter thought the couple should or should not have been allowed to be sexual.ResultsOne primary theme was identified: conditions necessary for someone to be sexual. Six categories were identified within this theme, with the public commentary considering factors such as marital relationships, intimacy needs and several sexual consent‐related issues as key conditions necessary to be sexual in a nursing home setting. Overall, the majority of commenters were in support of sexual expression for an individual with dementia in the described situation.DiscussionThis study revealed sexual expression among individuals with dementia is a contentious issue with strong public opinions about how this should be managed in a nursing home setting. These opinions should be considered as policy related to sexual expression in nursing homes is developed.

Public acceptability of public health policy to improve population health: A population‐based survey

“…Since the 1930s, politicians, researchers and the media have been using a variety of methods (eg face‐to‐face, telephone or online surveys; citizen juries or discussion groups) to measure public opinion across a wide range of topics . Internationally, however, while research has explored the public acceptability of different mechanisms of delivering policy messages, relatively few nationally representative public opinion surveys have attempted to identify public acceptance of different health priorities and policies .…”

Public perspectives toward long-term care staff's interventions in the sexual relationships of residents with dementia

“…In one instance, a 78-year-old man was charged, though ultimately acquitted, with raping his wife whom had dementia and resided in an LTC facility (Jaffe, 2015). Similar cases are raising important questions about how LTC facilities handle these issues, which has ultimately drawn considerable public attention (Belluck, 2015;Syme et al, 2017).…”

“…The public, however, has offered polarizing views on sexual expression among older adults with dementia (e.g. Syme et al, 2017); yet, a review of the literature highlights major disagreements between what the public views as acceptable and what scholars cite to be the most beneficial for the resident (e.g. Wilkins, 2015).…”

Public Perspectives Toward the Sexual Behavior of an Individual With Dementia Residing in Long-Term Care

“…Such intimate relationships and sexual behaviors are known to continue even after a diagnosis of a dementia-related disease, as cognitive impairment does not reduce one’s physical ability and intrinsic desire to remain intimate and sexual (Di Napoli et al, 2013; Elias & Ryan, 2011; Kamel & Hajjar, 2004; Katz, 2013; Reingold & Burros, 2004). Despite this, the basic human right of adult sexual autonomy for a dementia sufferer is often challenged, driven by the perceived or actual inability of a resident with dementia to demonstrate consent in an accepted way (Syme et al, 2016; Tarzia, Fetherstonhaugh, & Bauer, 2012). There is an overwhelming gap in understanding how sexual consent criteria are defined and assessed for those with dementia-related disease (Lyden, 2007), which presumably fuels the lack of overarching policy on which to base acceptable staff responses and care-related decisions within LTC facilities.…”

“…Discussion among the general public about sexual practices in LTC settings has highlighted the debate on competence and consent-related issues as an influencing factor of opinions about older adults with dementia engaging in sexual behavior while in LTC (Belluck, 2015; Syme et al, 2016). However, few studies have empirically examined public perspectives toward sexuality among older adults with dementia residing in LTC facilities.…”