Sexuality in nursing homes: practice and policy

Older adults' sexuality and sexual expression are often overlooked in nursing home and residential care settings. Despite cultural beliefs that this population is asexual, sexual activity occurs frequently among residents in long-term care. This study, using written survey instrumentation, examines the scope of resident sexuality, staff reactions to sexual behavior, and the policies and guidelines used in 91 nursing homes to address residents' sexual activity. Eighty-five percent of respondents reported that sexual activity had occurred in their homes, and staff reactions to sexual activity were based on general guidelines. Many responses indicated that sexual expression of residents was considered non-normative. Issues of consent, especially concerning residents with dementia, and residents' right to privacy were addressed using existing general policies. Survey results demonstrate a need for specific policies and staff training regarding sexual expression to be developed with the input of nurses, family members, and residents.