Supporting Sexual Activity in Long-Term Care

Everett, Bethan

doi:10.1177/0969733007083937

Cited by 18 publications

(32 citation statements)

References 7 publications

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“…Therefore, non‐pharmacological strategies (e.g., providing relevant information that will help the resident to reduce potential harms, encouraging the resident to take appropriate precautions, bringing the resident to a private room) should always be prioritised (Joller et al., ; Ozkan et al., ; Tucker, ), and pharmacological and physical restraint should be limited to only crisis situations when inappropriate sexual behaviours constitute a risk for the staff or the other residents (Bauer, Fetherstonhaugh, Tarzia, Nay, & Beattie, ; Everett, ). To this regard, Everett () offers a valuable tool to understand when the interference with patients’ wishes and behaviours is permissible. Based on Everett's framework, interference is only permissible when it is “ effective, it does not create a greater harm than it prevents, it is the mildest possible, it is not discriminatory, and thought justifiable by those upon whom it is imposed ” (Everett, , appendix 2, p. 96).…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experiences and reactions towards intimacy and sexuality expressions by nursing home residents: A qualitative study

Thys

Mahieu

Cavolo

et al. 2018

Journal of Clinical Nursing

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Objectives To better understand how nurses experience and react to intimate and sexual expressions of nursing home residents. Background Although many nursing home residents continue to desire intimacy and sexual expression, they commonly perceive negative attitudes of nursing staff towards them as a major barrier to their sexual well‐being. To eliminate this barrier, it is crucial to gain a more in‐depth understanding of nurses’ personal experiences and reactions towards intimacy and sexuality in aged care. Design Our study used a qualitative design, rooted in grounded theory. Methods Semi‐structured interviews with 15 nurses between 34 and 59 years of age were conducted. Participating nurses were recruited from seven different nursing homes in Flanders, Belgium. We used the Qualitative Analysis Guide of Leuven (QUAGOL) for data analysis. We followed the COREQ guidelines to ensure rigour in our study. Results Nurses experienced and dealt with intimate and sexual expressions of residents in an individual way, which was focused on setting and respecting their own sexual boundaries and those of residents and family members. Depending on their comfort level with residents’ expressions, nurses responded in three ways: active facilitation, tolerance and termination. Nurses’ responses depended on contextual factors, including their personal experiences with sexuality, the nature of their relationship with the residents involved, the presence of dementia and the organisational culture of the facility. Conclusions Nurses face a wide range of experiences and emotions when confronted with residents’ expressions of sexuality and intimacy. A supportive approach is needed to guide nurses in dealing with these highly sensitive situations. This approach can be promoted at the institutional level through continuous educational programmes. Relevance to clinical practice This study advocates a contextual and interpretative ethical approach to sexuality in older adults, taking as starting point nurses’ own vulnerability and that of residents and relatives.

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Section: Discussionmentioning

confidence: 99%

Nurses’ experiences and reactions towards intimacy and sexuality expressions by nursing home residents: A qualitative study

Thys

Mahieu

Cavolo

et al. 2018

Journal of Clinical Nursing

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“…68 However, when the capacity of one or both of the people involved is called into question (and it should be noted that assessment of capacity is not always straightforward 68,69 and can easily be underestimated in people with dementia 38 ) then balancing rights to sexual expression with risks of sexual abuse and exploitation is often challenging. Care homes have a duty to protect their residents, but also a duty to uphold residents' rights to autonomy and respect for their private lives.…”

Section: Legal Perspectivesmentioning

confidence: 99%

‘Inappropriate’ sexual behaviours in dementia

Ward

Manchip

2012

Rev. Clin. Gerontol.

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SummaryHuman sexuality is a complex interaction of biological, social and emotional factors. When any or all of these factors are disrupted by a progressive dementia it is unsurprising that sexual ‘problems’ are identified. Most sexual behaviour ‘problems’ relate to expressions of normal sexuality complicated by changes in relationships, care needs and cognitive function, and complex ethical and legal considerations emerge. Rarely, new and severe hypersexual or paraphilic behaviours arise de novo, usually due to damage to certain brain areas, and sometimes due to medication side-effects, psychiatric disorder or delirium. Evidence and approaches to assess and to manage sexual behaviour problems in dementia are discussed.

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“…Literature exists regarding the ethics of allowing and facilitating sexual relationships in long-term care. [74][75][76][77][78][79] To effectively evaluate whether nursing home residents should be able to participate in intimate relationships, nursing home staff must assess each resident's sexual consent capacity. Several approaches for assessment of sexual activity within nursing homes have been presented in the literature, 74 based on residents' ability to perform sexual acts voluntarily and to understand the consequences of their actions.…”

Section: Ethical and Policy Concerns In Rrsamentioning

confidence: 99%

Sexual Aggression Between Residents in Nursing Homes: Literature Synthesis of an Underrecognized Problem

Rosen

Lachs

Pillemer

2010

J American Geriatrics Society

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Evidence exists suggesting that most sexual aggression against older adults occurs in long-term care facilities. Fellow residents are the most common perpetrators, often due to inappropriate hypersexual behavior caused by dementing illness. This resident-to-resident sexual aggression (RRSA) is defined as sexual interactions between long-term care residents that in a community setting would likely be construed as unwelcome by at least one of the recipients and have high potential to cause physical or psychological distress in one or both of the involved. Although RRSA may be common and physical and psychological consequences for victims may be significant, this phenomenon has received little direct attention from researchers to date. We review the existing literature and relevant related research examining elder sexual abuse and hypersexual behavior to describe the epidemiologic features of this phenomenon, including risk factors for perpetrators and victims. Preventing and managing sexual aggression in nursing homes is made more challenging due to the legitimate and recognized need for nursing home residents, even those with advanced dementing illness, to sexually express themselves. We discuss the ethical dilemma this situation creates and the need to evaluate the capacity to consent to sexual activity among residents with dementing illness and to re-evaluate capacity as the diseases progress. We offer suggestions for managing RRSA incidents and for future research, including the importance of designing effective interventions.

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Supporting Sexual Activity in Long-Term Care

Cited by 18 publications

References 7 publications

Nurses’ experiences and reactions towards intimacy and sexuality expressions by nursing home residents: A qualitative study

Nurses’ experiences and reactions towards intimacy and sexuality expressions by nursing home residents: A qualitative study

‘Inappropriate’ sexual behaviours in dementia

Sexual Aggression Between Residents in Nursing Homes: Literature Synthesis of an Underrecognized Problem

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