State and federal regulations weren’t enacted to protect nursing home residents only from neglect and abuse. Federal law requires facilities to maintain environments that promote, maintain or enhance a resident’s quality of life. Adults have the right to make choices about significant aspects of their life in a facility. Indeed, the facility must make reasonable accommodations for the individual resident’s needs and preferences to the extent that the health and safety of the individual resident or others is not endangered.
Certainly, these rights include the right to enjoy social and human relationships, including sexual intimacy. But should, and can, long-term care facilities condone or even facilitate sexual intimacy between their residents?
Naturally, only consensual relations between competent adults can be permitted. When it is clear that two residents have the capacity to consent, some nursing home operators believe that facilities can and should have a policy that not only permits sexual contact between residents but also accommodates them while protecting their privacy. Indeed, Daniel Reingold, Chairman and CEO of Hebrew Home for the Aged at Riverdale in Bronx, NY, stated in support of the facility’s policy, “we honor what remains in a person, not what’s gone.”
Facilities such as Hebrew Home train staff on how to react to and recognize a blossoming relationship and to counsel the couple on safe practices. They should also be trained on how to react to the discovery of two patients having sex so as to avoid embarrassing or interrupting them.
It is also important that the facility avoid interjecting their moral or religious beliefs into their residents’ relationships, for example, known adultery or even homosexual relations. Facilities may and should also consider implementing a policy for conjugal visits between residents and non-residents.
Ultimately, as Reingold believes, under the right circumstances, romantic and sexual intimacy can be good for the residents, particularly because they face loss of so many relationships at this stage of their lives.
The danger, of course, arises when there is an issue about a resident’s capacity to consent, such as when a resident has dementia. This is not a black-and-white analysis and requires an interdisciplinary approach among the staff that includes the family.
But when there is no issue about the competency of the resident, the law certainly supports the promotion of nursing home residents’ rights to sexual intimacy. While some may find the thought of one of their parents engaging in such conduct uncomfortable, ultimately most people want our elderly parents to enjoy the last years of their lives to the fullest. Isn’t this something we would want for ourselves?