Ethical dilemmas concerning sexuality of elderly patients suffering from dementia

This study endeavoured to clarify the ethical dilemmas concerning sexuality encountered by nurses caring for elderly patients suffering from dementia, and to assist the decision-making process of the nurses and staff who handle dilemmas of this nature. Many of the staff in geriatric institutions report difficulties, confusion, embarrassment and helplessness as well as negative responses and rejection when encountering sexual situations between patients of the same or different sex, patients and staff members or between patients and visitors. Embarrassment over sexuality is felt by staff members, visitors and family. This embarrassment may result in elderly patients being treated like children, and being separated from their partners. A response of this nature can provoke anger in the patients, sometimes leading to violence. The central dilemma on the subject of sexuality in a geriatric institution is the fact that staff are in conflict between the desire to protect the elderly patients and maintain their dignity and the patients' desire to fulfil their sexual needs. Since no single, definitive prescription can be provided for conduct acceptable to the staff, the patients and their families, it was decided to work with the staff on the basis of case studies to help them in selecting ways of coping.