K-State helps nursing home staff become comfortable with residents' sexual expression

November 18, 2008

"Do not disturb" signs aren't just for newlyweds anymore. They are also a way to give nursing home residents some privacy for sexual expression, according to Kansas State University aging experts.

"By law you can't always lock a room, but you can offer residents some privacy," said Gayle Doll, who directs K-State's Center on Aging.

She said semi-private rooms pose a problem for nursing home residents who want to engage in sexual activity, either alone or with a partner. That's why two of the center's researchers are looking at ways to make nursing home staff more comfortable accommodating the sexual needs of residents.

Doll said that because nursing home staff don't receive any education in this area, they tend to either ignore or condemn these needs.

"We just want people to start talking about these issues," she said. "Once you start talking about it with nursing home staff, everyone has a story."

Majka Jankowiak and Laci Cornelison, research assistants at the Center on Aging, studied nursing home staff attitudes about sexuality in three Kansas nursing homes. The research was presented in October at the American Association of Homes and Services for the Aging conference.

The researchers surveyed the staff before and after a workshop they presented. The surveys, as well as anecdotal feedback from the participants, showed a marked change in attitudes.

"They really felt this was a topic that they needed to be educated on," Jankowiak said. "Part of it is that American society is not supportive of older people and sex. It's been a taboo, and it's an even bigger taboo in nursing homes. After the presentation, the participants felt more confident talking about it and dealing with sexual expression of residents."

These shifting attitudes translated into a positive experience for one particular couple, Cornelison said. A married couple moved into a nursing home room with two hospital beds. One spouse had to have a leg elevated, but it was on the same side as the partner's bed, which made it hard for them to hold hands. Some staff members didn't see the importance of allowing the couple intimacy and said the problem couldn't be fixed.

"But someone who had been to our presentation encouraged everyone to move the furniture," Cornelison said.

The researchers said that sexuality and nursing home residents brings up issues beyond just acknowledging and accommodating sexual expression. HIV and other sexually transmitted diseases can be concerns for a generation that may have not have the same awareness that younger people do.

Also, adult children may have concerns about their parent's safety or how a new relationship will affect the family or their inheritance. The researchers are developing materials to help family members deal with these questions.

"What they fear is exploitation or that the role the parent played will go away," Doll said.

In addition, Alzheimer's and dementia raise questions about the ability to consent, and these conditions also may spur sexual behavior that's inappropriate.

"Even though we advocate for residents' rights, there are things that are inappropriate," Doll said. "But staff must be able handle this without residents feeling embarrassed. Inappropriate behavior can just come from people needing relationships, not necessarily sexual ones."

Doll said the researchers hope to see federal guidelines developed to help all nursing homes deal with sexuality in a positive way, especially as baby boomers age and bring their attitudes about sex with them to the nursing home.

"Nursing homes are the second most regulated industry next to nuclear power, and yet these regulations don't address sexuality," Doll said.

Source: Kansas State University