Sexuality and the Human Rights of Persons With Dementia

Peisah, Carmelle; Ayalon, Liat; Verbeek, Hilde; Benbow, Susan M.; Wiskerke, Esther; Rabheru, Kiran; Sorinmade, Oluwatoyin

doi:10.1016/j.jagp.2021.05.016

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Nurses' capability to include personal boundaries in these situations benefits their wellbeing and the care relation (Waterschoot et al, 2021 ). Viewpoints in current research on intimacy and sexuality in dementia care are relatively one-dimensional as, often, nurses are either portrayed as victims of sexual harassment or accountable for unmet resident needs due to inadequate attitudes or lack of knowledge (Haesler et al, 2016 ; Kontos et al, 2016 ; Villar et al, 2020 ; Peisah et al, 2021 ). Quantitative studies aiming to nuance, bridge differences, or empower nurses might benefit from applying the IPB scale.…”

Section: Discussionmentioning

confidence: 99%

Including personal boundaries scale: development and psychometric properties of a measurement for nurses' self-efficacy toward intimate and sexual behavior in dementia care

Waterschoot,

Roelofs,

van Dam

et al. 2024

Front. Dement.

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BackgroundPerson-centered nursing home care recognizes the intimate and sexual needs of residents with dementia but lacks guidance for nurses to address them while effectively respecting their personal boundaries. The Including Personal Boundaries (IPB) scale was developed to complement clinical and scientific efforts to support both nurse and resident wellbeing.MethodsThrough a co-creative process, theoretical principles, day-to-day experiences, and expert knowledge were integrated into an initial nineteen-item version of the IPB scale. The pilot sample comprised 297 Dutch (vocational) nurses in dementia nursing care.ResultsAfter Principal Component Analysis, nine items with strong factor loadings (>0.6) were retained. Internal reliability measures supported the item selection, such as high internal consistency (α = 0.866) and adequate corrected item-total correlations (0.532–0.781).ConclusionThe presented IPB scale, a nine-item scale, is a short, robust measure to assess nurses' self-efficacy in their capabilities to include personal boundaries (physical and emotional) when confronted with the intimate and sexual behaviors of residents with dementia. Further validation is recommended. The IPB scale could provide valuable insights for research, clinical practice, and education.

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Section: Discussionmentioning

confidence: 99%

Including personal boundaries scale: development and psychometric properties of a measurement for nurses' self-efficacy toward intimate and sexual behavior in dementia care

Waterschoot,

Roelofs,

van Dam

et al. 2024

Front. Dement.

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“…13. respect for family, relationships, sexual health, and the right to intimacy [24]; 14. confidentiality and privacy; and 15. to practice a spiritual life of one's choosing [25].…”

Section: Accessible Leisure and Education As Available To Other Citiz...mentioning

confidence: 99%

Towards a WPA Position Document on the Human Rights of Older Adults with Mental Health Conditions

Lima¹

2022

Consortium Psychiatricum

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The increasing number of older adults in countries across the world is a huge challenge to those that are in charge of promoting, protecting, and implementing their human rights. This task is particularly difficult in the absence of a strong international framework addressing the principles required to guide the actions to combat all human rights violations. The existence of such a specific framework for older adults with mental health conditions is justified in view of the particular vulnerability of this section of the population by virtue of societal ageism, stigmatization, exclusion, as well as the disability and dependency which mental health conditions in old age may confer. The present article is a development of a previous statement by the International Psychogeriatric Association and the World Psychiatric Association Section of Old Age Psychiatry. As there is a call to all organizations to support efforts to combat Human Rights violations among older adults, a text will be submitted to the Executive Committee of the World Psychiatric Association to approve an official position statement on Human Rights of Older Persons with Mental Health Conditions.

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“…Moreover, many jurisdictions also have reporting requirements for healthcare professionals that mandate reporting of all cases of suspected and/or actual sexual abuse ( Grigorovich & Kontos, 2020 ; Quinlan & Smele, 2017 ). While these types of legislation were not explicitly implemented to restrict positive sexual expression of persons living with dementia, they pose a significant barrier to such expression by reinforcing ableism and ageism ( Fischel & O'Connell, 2015 ; Goldberg, 2018 ; Peisah et al, 2021 ). In the context of the risk-averse culture of RLTC, such legislation legitimizes the default practice of restricting sexual expression of people with dementia based on the belief that it is unintentional and/or not consensual, and thus always harmful ( Howard et al, 2019 ; Sandberg et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, it is our contention that a human rights-based approach is a more productive way forward because it treats the support of positive sexual expression as a matter of social justice that governments have the obligation to attend to using law and public policy. With a human rights approach to dementia and sexuality, the barriers that persons living with dementia experience are treated as a form of discrimination based on age and ability, and attention is focused on the denial of their human rights to dignity, autonomy, and participation in everyday life and society ( Grigorovich & Kontos, 2018 ; Kontos et al, 2016 ; Peisah et al, 2021 ). This is because a human rights approach recognizes that all persons, regardless of their abilities and age, have an entitlement to experience positive sexual expression on an equal footing, and it is implied that states and their institutions have an obligation “to act in ways that do not produce or perpetuate barriers to equality and the equal enjoyment of [sexual] rights, including the highest attainable standard” ( Miller et al, 2015 , p. 22).…”

Section: Introductionmentioning

confidence: 99%

Dementia and sexuality in long-term care: Incompatible bedfellows?

et al. 2021

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Despite the recognized benefits of sexual expression and its importance in the lives of people living with dementia, research demonstrates that there are multiple barriers to its positive expression (e.g., expression that is pleasurable and free of coercion, discrimination, and violence) in RLTC homes. These barriers constitute a form of discrimination based on age and ability, and violate the rights of persons living with dementia to dignity, autonomy, and participation in everyday life and society. Drawing on a human rights approach to dementia and sexual expression, we explored the experiences of diverse professionals, family members, and persons living with dementia with explicit attention to the ways in which macro-level dynamics are influencing the support, or lack thereof, for sexual expression at the micro level. Focus groups and in-depth interviews were conducted with 27 participants, and the collected data were analyzed thematically. While all participants acknowledged that intimacy and sexual expression of persons living with dementia should be supported, rarely is such expression supported in practice. Micro-level factors included negative attitudes of professionals toward sexual expression by persons living with dementia, their discomfort with facilitating intimacy and sexual expression in the context of their professional roles, their anxieties regarding potential negative reactions from family members, and concerns about sanctions for failing to prevent abuse. In our analysis, we importantly trace these micro-level factors to macro-level factors. The latter include the cultural stigma associated with dementia, ageism, ableism, and erotophobia, all of which are reproduced in, and reinforced by, professionals’ education, as well as legal and professional standards that exclusively focus on managing and safeguarding residents from abuse. Our analysis demonstrates a complexity that has enormous potential to inform future research that is critically needed for the development of educational initiatives and to promote policy changes in this area.

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Sexuality and the Human Rights of Persons With Dementia

Cited by 7 publications

References 32 publications

Including personal boundaries scale: development and psychometric properties of a measurement for nurses' self-efficacy toward intimate and sexual behavior in dementia care

Including personal boundaries scale: development and psychometric properties of a measurement for nurses' self-efficacy toward intimate and sexual behavior in dementia care

Towards a WPA Position Document on the Human Rights of Older Adults with Mental Health Conditions

Dementia and sexuality in long-term care: Incompatible bedfellows?

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