Entering a long-term care home shouldn’t be a sexual death sentence.
But accommodating the intimate desires of seniors, particularly when it concerns those who are queer and/or struggling with dementia, can be a delicate business.
Taboos and moral and ethical dilemmas will be explored at a session called Please Knock Before Entering: Intimacy and Sexuality in Care Homes at the Terminal City Club, April 8.
“We’re really trying to normalize the fact that seniors have a sex life,” said Catherine Kohm, panelist and executive director of Haro Park Centre in the West End. “People think you come into an institution and your sexual needs and desires disappear and that’s not true.”
Consent can be a cloudy issue for those suffering with dementia. Staff at Haro Park has had to handle cases where a husband who lives outside the long-term care home wants to have sex with his cognitively impaired wife. They’ve had to discuss with the resident, her partner, substitute decision makers and staff whether consent is possible. In some cases, the door to the wife’s room had to be left open, no clothing could be removed and physical intimacy meant handholding.
Residents in different tiers of care can strike up sexual relationships, sometimes even when they have a partner on the outside.
Haro Park Centre staff have also dealt with a “very vulnerable” senior bringing a suspect person from the street back to the care home.
“It’s just talking about it and trying to be respectful of individual agency and what people want and what’s safe and making sure that our morals, values, don’t get in the way,” Kohm said. “And if somebody chooses to have posters or pornographic pictures in their room, you know what? That’s their room. They can do whatever they want.”
Intimacy among older people within a facility can require physical accommodations such assistance getting into bed or a bed lift.
“And then do you call when you’re done?” Kohm said. “Or some people who are incontinent, how do you clean yourself after.”
She added a sex surrogate like the one Helen Hunt played in the movie The Sessions, could be a good idea.
“What’s the outlet for people?” Kohm said. “Physically, how do some people even masturbate?”
Heather Campbell, director of policy and research at the B.C. Care Providers Association, which is hosting the Care to Chat session, says family members are often surprised they don’t get to make decisions about their loved one’s intimate activities.
“That mom in a care home, as long as she has capacity, it’s up to her in terms of what she wants to engage in,” Campbell said. “Having a power of attorney or a representation agreement doesn’t necessarily give you the authority to make those decisions with respect to somebody’s sexual activity.”
Being respectful of gay, bisexual, lesbian and transgender residents and responding to bigoted bullying is also key.
“We’ve done sensitivity training with staff about sexual issues, LGBT issues, diversity issues,” Kohm said. “It’s ongoing.”
Campbell said institutions need to explore best practices. She’s heard of a care home in Europe that holds pornography nights that appear to reduce the aggression of people with dementia.
“Way back when I started my career, we would just never talked about this, ever,” Kohm said.
She started in acute care 35 years ago and all the talk was about illness.
“In long-term care, this is not about the illness or the deficits we’re living with,” she said. “This is about living life and getting as much enjoyment as we can.”
Maureen McGrath, host of CKNW’s Sunday Night Sex Show, will deliver the keynote address at Please Knock Before Entering and join the panel discussion moderated by Sophie Lui, anchor of Global BC’s Morning News. The session starts at noon at 837 West Hastings St.
To register, see bccare.ca/events.