Too taboo to talk?
Residential aged care managers and care staff are being encouraged to learn more about their roles and responsibilities when it comes to sex and older people living with dementia.
Residential aged care managers need to talk about the unmentionable and address the topic of sex and dementia, otherwise care staff will become misguided and confused about what their responsibilities are.
La Trobe University Associate Professor Sally Garratt, will brace the taboo subject of dementia and sexuality in front of a 200-strong audience of paid and unpaid carers at an Alzheimer’s Australia Victoria seminar in Hawthorn today.
The seminar will be hosted by ABC Radio National broadcaster Peter Mares, and feature an expert panel including Associate Professor Garratt; community care trainer, Anna Makedonskaya; a former carer who looked after her husband following a dementia diagnosis at age 54, Liz Fenwick; Alzheimer’s Australia Vic educator, Jenne Perlstein; and from the Office of Public Advocate, Helen Rushford.
“Obviously as people age, they don’t lose their sexuality,” Associate Professor Sally Garratt said.
“You are still a whole person. In residential aged care, staff tend to forget that there are human needs that don’t go away just because you age. Older people with dementia still need to be touched, cuddled and feel like a person.
“What happens with dementia is that you loose your social morals and you can become quite disinhibited. Usually, if there’s a need for something it is instant gratification.
“The thing about touching people is that there are no guidelines or policies to assist staff to say what is appropriate.”
As a national project, Alzheimer’s Australia has recently developed a new Quality Dementia Care (QDC) book and seminar series with Associate Professor Garratt to provide residential aged care staff with advice on how to handle certain situations and behaviours, information about the rights of residents and the responsibilities of staff.
“Consent with people who have lost quite a bit of cognition is always an issue,” she said. If two people form a relationship in a facility, which often happens, they should have the power to say and do what they please in their home. However if one is really demented and one is not, then you have to be careful that no harm is being done.
“The issue of consent is that you have to be able to understand the issues associated with the consequences of what you decide to do. Sexual activity has a consequence of pleasure.
“Everyone needs a bit of hedonism and pleasure in their life. So to disrupt a relationship because it is upsetting staff is not a nice thing to do. But, on the other hand, it is so complicated because family, and often a visiting spouse, is involved.”
Associate Professor Garratt recommends that residential aged care managers understand all of the issues involved and write policies to assist their staff to do the right thing.
“[Management] are involved in risk management and they need to define what they mean by the risk posed by sexuality. No one is going to get pregnant and [there is a low risk] of sexually transmitted diseases. So, does the risk outweigh the benefit or does the benefit outweigh the risk?
“The other thing is the need to educate a resident’s family. Families often don’t understand dementia at the best of time and they need to be counselled and be made to understand what is actually going on.
“It is a very complex issue. People are grappling with it. I’m really disillusioned with places that don’t consider the issue properly and they’ve got to do it. Sex and dementia has to be out in the open.”
