Seniors and Sex in Assisted Living

By Michelle Seitzer / Posted on 12 December 2012

I know. You don’t want to think about seniors in assisted living as having sex, but remember, there are married couples — and others who may be exploring new relationships late in life — living in these residential communities. It’s normal. It’s not a bad thing. Freedom of sexual expression at times may present an issue though, primarily because of the community living setting.

Linda Rhodes, a former state secretary of aging in Pennsylvania, recently wrote a three-part series for PennLive.com on Sexuality, Intimacy and Aging. Her third post entitled People in Assisted Living Need Intimacy pulled back the curtain on the sticky situations and “challenges of intimacy” faced by couples and individuals dealing with dementia, particularly those in assisted living and other communal care settings.

Rhodes gets right to the point early on in the piece, stating, “…like it or not, we do need to talk about, plan for and respond to the needs of older adults who might have some form of dementia.”

She’s right. Whether it makes you cringe, blush or giggle doesn’t matter. Seniors need intimacy; privacy and autonomy is important, too.

A dementia or Alzheimer’s diagnosis doesn’t negate these needs either; this reality has been portrayed in the 2006 movie Away From Her (starring Julie Christie), in a recent storyline in the popular TV show Grey’s Anatomy, and also off-screen, when former Supreme Court Justice Sandra Day O’Connor spoke openly about her husband’s romantic relationship in assisted living. In these situations, it’s difficult for the well spouse to reconcile their partner’s need for sexual expression with the fact that the disease has compromised their memory and therefore their ability to satisfy that need as they used to in their marriage relationships. However, intercourse is not always necessary for that need to be met, according to Dr. Karen Hicks, adjunct professor of Human Sexuality and Women’s Reproductive Health at Lehigh University, whose work Rhodes references in her PennLive.com post.

Says Hicks, “The intimacy needs of the elderly aren’t always expressed through intercourse. It can be met by snuggling, holding hands or simply sleeping together. Many older people in facilities are starving to be touched. Providing them with physical affirmation by an arm around the shoulder, holding their hands while speaking or the opportunity to pet a furry dog or cat can go a long way to feeling connected and loved.”

Hicks presents seminars to staff in assisted living, who often find themselves unsure of how to deal with sexual relationships between residents who have dementia, particularly when it comes to issues of informed consent and the family’s view of the relationship. I can recall being in this difficult position on more than one occasion during my time in assisted living. Often, the family members asked us to “make it stop,” to prevent their parent/relative from being anywhere near the person with whom they were having a relationship, whether it had led to sex or not.

How would Hicks advise her seminar attendees to respond?

“Couples, whether they are consenting adults within a facility or a well spouse visiting his loved one, should be provided private space to physically express their love for each other.” To the adult children who are uncomfortable with their parents’ new relationship(s), she suggests taking the time to “reflect upon our own feelings, values and beliefs about sex and intimacy before deciding what to do in response to an older individual’s appropriate or inappropriate sexual behavior.”

Trust me, this is rocky territory. It’s uncomfortable to talk, think or write about, since there really aren’t any easy answers. That doesn’t mean we shouldn’t talk, think or write about it though, because at some point in our lives, we will probably have to deal with similar situations, whether in our own relationships or those of a loved one. It wouldn’t hurt to open the dialogue now.

Read more about the subject here at our blog:



Do you have something to say?