The quick answer is, not necessarily. The reality is we are all sexual beings, and many people wish to continue an active sex life into their older age. It may be that you currently have a partner, and you are facing separation due to the need for residential care, perhaps your partner is with you in care; then again you could be contemplating a new intimate relationship with a resident; whatever your situation, enjoying an active sexual life in a residential care setting can be somewhat of a challenge.
The majority of the obstacles sadly stem from other people's misconceptions, prejudices, disapproval and lack of knowledge. This combined with the possible logistics and the fact that the home is a place shared with others makes the ability to engage in an intimate relationship even more difficult.
Residents are generally aware that their sexual behaviour, needs and values etc. may be very different to others (staff, residents, and family members) and they factor this into their decision making (which can be quite limiting and even stifling).
Other people
In the residential care setting you are obliged to live at close proximity with others. The human dynamics around you will impact on you much more than they would have in the wider community. Possible things you may have to contend with range from the lack of knowledge around this subject by staff (and others), the 'sensibilities' of your own family/families, through to the issue of dementia.
Many people find it difficult to talk about the sexuality of older people. They are often shocked at the thought of older people having a sexual relationship; others may feel awkward or express a judgmental attitude. You may even remember feeling that way yourself. It is not uncommon either for a staff member to discourage a blossoming relationship because they lack the skill to know how to handle it properly. Poor management of such situations can be demoralizing for residents. Older people like to be 'fancied' too. "When allowed to engage in relationships with others, these positive experiences enable (d) them to feel joyful, special, loved and attractive again." (Promoting awareness of sexuality of older people in residential care. Lisa Low et al)
Managers of residential care facilities are now more aware of these issues. In fact, resident's rights to intimacy are a component of staff training. While staff are trained to be mindful of their own values, culture and customs and not to impose those on residents, the reality is that some people struggle with this.
Family sensibilities can be another issue. It's one thing if mum and dad want to have sex at the rest home but it seems to be another thing if the person 'in care' forms a new relationship and wants to have sex with someone else. The reaction is not always positive. Many families feel they have a right to decide whether their parent/s can or cannot have a sexual relationship even if their parent/s are still considered capable of making their own decisions. They can feel rejected, threatened, distressed and in some instances concerned about remarriage and inheritance issues. Over time, particularly if their parent is single, most families are generally very supportive and pleased. They find it comforting that there is someone else nearby who is important in their parent's life.
Dementia brings its own set of issues when it comes to sexuality. Staff in dementia care facilities are generally used to residents forming relationships; often platonic but sometimes more intimate. Occasionally the person with dementia will form a relationship with another resident, to the initial consternation of their partner (if they have one). There are a number of reasons why this occurs but most commonly it is due to mistaken identity, seeking physical closeness or needing relief from sexual tension. Staff should be understanding about this situation and in many instances will have the skill to be able to work this through with the individuals or family concerned. If they don't, we suggest you contact Alzheimers New Zealand or Dementia NZ excellent sources for support and somewhere you can safely debrief.
It goes without saying that staff/resident relationships are not permitted. A professional distance should be maintained at all times between staff and residents.
If you want to engage the services of a sex worker, you have the right to do so. You need to be aware of others differing opinions about this subject so keeping this arrangement private is wise. If you need assistance procuring these services speak to someone who you know will treat this in a professional, confidential way.
Privacy
It is not always easy to ensure the degree of privacy that one would wish for in a residential care facility. You probably require assistance by staff for your activities of daily living and this means that, by necessity they will come and go from your room frequently. They also need to have easy access to your room in the event of an accident, emergency etc.
There are a number of things that can be done to increase the sense of privacy. Staff know that they should knock and wait to be invited into your room before entering. Ask them to do this as nicely but firmly as possible. Tell them you need your quiet and uninterrupted time. Senior staff can help by reinforcing this and talking quietly with their colleagues. A 'Please do not disturb' sign on the door is another possibility. Put this up whenever you want a quiet time. Everyone therefore gets used to the idea that you want uninterrupted time for a variety of reasons. Discuss other options with senior staff.
Occasionally other residents may inadvertently come into your room. If there are residents who bother you in this way talk to management about possible solutions.
Double beds
While a double bed isn't essential for the enjoyment of intimacy, for some couples it is quite important. Occasionally facilities can accommodate the request to bring in a double bed. The room needs to be big enough to provide sufficient free space around the bed for staff to carry out their tasks in safety. It is also needs to be pointed out that it is more difficult for the staff to provide nursing care to someone in a double bed.
Consent
There is no quick and easy answer to this subject. The following is a brief overview of the issue of consent.
Close relationships are enjoyable to both parties and it is usually evident to others in body language and a multitude of other ways, so, while not always so, the distress of one party is often evident. Staff will generally intervene in any situation if they suspect it is not consensual or is causing distress to one of the parties. When the relationship becomes intimate it needs to occur in a private place.
If you as a resident are beginning a new intimate relationship it is vital to ensure that the other person involved is agreeable to this. If your partner is in a dementia care facility, recognizes you as the partner, can indicate to you if they want to be intimate with you (or not), and is enjoying this intimacy then it is not likely to cause concern to health professionals or staff. Consent can be a tricky issue particularly where dementia is concerned.
As there are vulnerable people in residential care anyone considered to have knowingly taken advantage of another person will face the consequences of their actions just as they would in the wider community.
While this research article What counts as Consent?* is lengthy and in depth it teases out the difficulties and complexity surrounding the issue of consent. (*2020 Mark Henrickson, Principal Investigator School of Social Work, Massey University Catherine Cook, Co-Investigator School of Nursing, AUT University Vanessa Schouten, Co-Investigator School of Humanities, Massey University Sandra McDonald Ngäti Whätua, Te Uri o Hau Co-Investigator Narges (Nilo) Atef Project Manager College of Health, Massey University)
Sexual Health
Older people are not immune to sexually transmitted infections. Usual precautions should be taken.
Viagra has played a part by raising the profile of the sexuality of older people. If you have concerns about sexual performance or other issues pertaining to sexual health please see your doctor.
Finally
The point to remember is if you live in a residential care facility it is your home and despite the restrictions imposed by your own health and the shared living environment, you need to be able to continue your lifestyle as freely as possible (as long as it does not infringe on the rights of others). Choose a home that will respect this and help you achieve your goals.
Updated: 13 Jul 2023