Washington D.C.: Putting up at retirement homes limits older adults' rights to sexual freedom because of a lack of policies regarding the issue and the actions of staff and administrators at these facilities.
According to a Georgia State University study, though assisted-living facilities emphasize independence and autonomy, the staff and administrators behave in ways that create an environment of surveillance.
This indicates conflict between autonomy and the protection of residents in regard to sexual freedom in assisted-living facilities. Regulations at these facilities may vary, but they share a mission of providing a home-like environment that emphasizes consumer choice, autonomy, privacy and control.
Despite this philosophy, the autonomy of residents may be significantly restricted, including their sexuality and intimacy choices. Sexual activity does not necessarily decrease with age.
The frequency of sexual activity in older adults is lower than in younger adults, but the majority maintains interest in sexual and intimate behaviour.
While assisted-living facilities have many rules, they typically lack systematic policies about how to manage sexual behaviour among residents, which falls under residents' rights, said author Elisabeth Burgess.
"Residents of assisted-living facilities have the right to certain things when they're in institutional care, but there's not an explicit right to sexuality," Burgess said. "There's oversight and responsibility for the health and wellbeing of people who live there, but that does not mean denying people the right to make choices. If you have a policy, you can say to the family when someone moves in, here are our policies and this is how issues are dealt with. In the absence of a policy, it becomes a case-by-case situation, and you don't have consistency in terms of what you do," he stated.
The study that involved participant observation and semi-structured interviews with administrative and care staff, residents and family members, as well as focus groups with staff, found that residents had rights to sexual and intimate behavior, but they provided justifications for exceptions and engaged in strategies that created an environment of surveillance, which discouraged and prevented sexual and intimate behaviour.
They emphasized their responsibility for the residents' health and safety, which often took precedence over other concerns.
Staff and administrators expressed concern about consent and cognitive impairment. More than two-thirds of residents in assisted-living facilities have some level of cognitive impairment, which can range from mild cognitive impairment to Alzheimer's Disease or other forms of dementia. They felt responsible for protecting residents and guarding against sexual abuse, even if a person wasn't officially diagnosed.
The study has been published in Journal of Gerontology: Psychological Sciences and Social Sciences.
