The right to love is considered to be an essential human right. But does that right apply to Alzheimer’s patients?
Consider the questions:
- Can people with Alzheimer’s disease or dementia, people who are often unable to recognize their own children, give their sound consent to sexual activity?
- If staff members in a long-term care facility walk into a patient’s room and discover a sexual encounter in progress, how can they tell whether the encounter was wanted or unwanted?
- Can Alzheimer’s sufferers recognize if they are victims of forced sex?
- Is it sexual abuse when a male resident of a nursing home has sex with a dementia patient who lives down the hall?
With more than 5.3 million Americans currently suffering from Alzheimer’s disease and more cases a certainty as the population continues to age, this complicated issue of consent is likely to come up more often. At the heart is a difficult question: Are people with Alzheimer’s disease and dementia legally considered to be able to control their own sexual decisions?
Several cases are winding their way through the courts right now. One example is the case of Henry Rayhons, a former Iowa legislator who was charged with sexually abusing his wife, Donna, an Alzheimer’s patient who lived in a nursing home. Featured on National Public Radio last year, this case is a compelling story and worth the listen for anyone with loved ones in long-term care facilities. Listen to (or read) the story here. The case was also profiled in an excellent article in Psychology Today that also discusses how long-term care facilities are working to respond to the issue.
Based on my own experience with clients, I know that while the stage of dementia is definitely a factor, and a person can have holes in their memory, it doesn’t automatically mean that the person is incapable of consenting to sex. Though the cognitive capacities of people with Alzheimer’s are impaired, there are degrees and fluctuations. It’s always changing, which makes it difficult to determine the person’s ability to consent to sex. It might vary from one moment to the next.
Though there are no easy, one-size-fits-all answers, the way we look at the questions makes a difference. I think it’s helpful to think of this as a “pendulum” issue. It’s easy to swing from one extreme or the other when the real goal is to find the balance. Are families too quick to wrest control away from loved ones with cognitive impairment? Under the guise of protecting family members from “abuse,” are we going too far? Are we trying to protect a person who doesn’t want or need protection?
As the courts, long-term care facilities and families continue to grapple with questions like these, it’s important to remember that no matter what the diagnosis, older adults with cognitive limitations are human beings who retain on some level the capacity to love and be loved.
