Sexuality in Assisted Living

Paula Span’s insight in the New York Times blog, the New Old Age, “Sexuality in Assisted Living: Intimacy without Privacy” is right on the money.  Sex and aging don’t fit together well in our youth-oriented minds.  They particularly don’t fit well in settings where the older person is dependent for care and personal privacy is often a long-lost, abstract concept.

During the nearly 20 years that we owned and operated memory care assisted living communities we were frequently reminded that our concept of aging and sexuality did not necessarily – or at all – match reality.  No matter the age of the person or their cognitive capacity, physical intimacy is still a real human need.

I think often of the woman who shared this need with me early in my career in a way that stuck with me.  She said, “I find myself craving human touch these days.  Since my husband died and my children are grown, no one really touches me anymore.  Just the thought of skin on skin becomes a physical craving for me.”

I learned to offer my hand often, and allow people to tentatively touch it, caress it, or hang onto it tightly.  I also learned how important it is to train everyone on the team about this need and how to support people in finding physical intimacy in a care setting.

Ms. Span is correct; we do use the term “appropriate” a lot in our training.  We talk about place (privacy vs public spaces), people (consenting and happy vs. anxious and resisting) and family (helping them understand the needs and the rights of their loved one).

But we do train – a lot.  Cultural differences affect the way people perceive intimacy and sexuality, especially in dependent elders, so cultural sensitivity is important in training.  Frequency of training is also important, because rarely does each situation or scenario present in the same way.  With a population of individuals at varying stages of dementia, if you think you’ve seen or heard it all, you’re in for a surprise.

“Sexuality and Dementia” is one of the online courses we offer to assisted living and home care organizations to train their teams.  It’s a great way to build a foundation of knowledge in this important area and can set the stage for discussions about individuals and concerns unique to the setting.  It’s a great starting point to creating a caring culture that recognizes the need for sexual expression and intimacy, at every stage of life.

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