Assessing Public Opinions of Sexual Advance Directives Among Older Adults With Dementia

This study used a mixed-method research design to examine public attitudes toward sexual advance directives (SADs), a theoretical legal document intended to protect the sexual rights of individuals across the lifespan. Respondents (N = 537) largely indicated that SADs should exist (65.4%) to preserve autonomy and protect resident rights, but they would not sign one right now (60.4%) because they were too young. Linear regression analyses revealed statistical associations between education level, relationship length, and sexual instrumentality for the existence of SADs, while gender, age, perceived importance of sexuality, and sexual self-disclosure were associated with whether a respondent would sign the document now. Overall analyses indicate that valuing sexual expression as a right, autonomy, sexuality in older age, and sexual communication led to a greater amount of general support for SADs. Respondents were sensitive to the concerns of SADs in the context of fluid consent between partners and their safety.