Researchers are prodding nursing home administrators to take a more resident-centered approach to developing sexual intimacy policies in their facilities, and they have info from a new survey to assist.
Experts from Kansas made their push for more nuanced policies in a new analysis, published recently in the Gerontologist. Too often, they note, approaches to resident sexuality are “devoid” of person-centered components. Increasing the quality of social experiences, including sexual ones, is crucial for nursing homes, authors note, as their absence can result in loneliness and poorer health outcomes for seniors.
To aid nursing home leaders in these efforts, study authors polled nearly 400 community-dwelling older adults, hoping to better understand their preferences when they eventually make their way to long-term care.
They presented survey respondents with a series of possible sexual scenarios that might occur in a nursing home between a man and a woman — with ascending levels of intimacy, and with various added factors, such as one partner having dementia — asking respondents to react. The results suggest that approval of sexual expression in long-term care is “generally high” among midlife and older adults, with an average rating of more than 5 on a 7-point scale, researchers found.
“One of the things we hope that nursing homes, administrators and their staffs will do is think about sexual expression as a resident right and choice issue,” said Maggie Syme, Ph.D., lead author of the study and an assistant professor with the Kansas State University Center on Aging. “If we are implementing person-centered care for our dining experiences, for our living rooms, for our built environment in our nursing homes, we need to be thinking about sexual expression from a person-centered viewpoint, as well, and understanding that resident choice and resident voice should be a part of the discussion. That’s one of the major takeaways.”
A second takeaway, she told McKnight’s, is that the public is taking a “nuanced” view to this issue, and “there is no reason” why nursing homes can’t think about a “risk continuum,” and how to support resident choice to the fullest extent possible.
Several situational factors affected the approval rating of survey respondents when it comes to sexual expression in nursing homes. Level of intimacy, for one, proved “highly influential” on people’s perceptions of appropriate behavior. In other words, the more intimate a behavior, the less appropriate it becomes. Another key factor was whether sexual behaviors indicated “assent” (such as increasing happiness or seeking out greater proximity to an intimate partner) versus a lack of assent (hiding from a partner, increased anxiety). Behaviors indicating a lack of assent decreased respondents’ appropriateness rating, the study found.
In the future, Syme said she hopes to conduct similar studies on nursing home leaders’ perceptions of sexual intimacy among their residents. She said she understands that this is a particularly difficult situation for SNFs to navigate, but there are established best practices to follow.
“I feel you, nursing home administrators,” she said. “This is a risky place to be, but the good news is that there are people that have nuanced policies on sexual expression that still exist, haven’t been taken down by surveyors, haven’t been dinged by the law, and are doing this in a very person-centered way, but it does take education at all levels to help people get on board with the idea that this doesn’t have to be black and white. It can be a continuum.”
