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A Sexual Bill of Rights in a Nursing Home!

Old they may be, but the residents of The Hebrew Home for the Aged at Riverdale still want sex, intimacy and privacy. And the Home wants to help them. In an innovative document, formally called “Policies and Procedures Concerning Sexual Expression at the Hebrew Home for the Aged at Riverdale,” the Home has created what amounts to a sexual bill of rights for its seniors.

The document, which was created through the efforts of staff, residents and their family members, reiterates respect for the “importance of emotional and physical intimacy” and offers residents certain rights (provided intimate acts are conducted by those who are of both age and ability to consent and do not have negative impact on the residents or staff).These include the right to “seek out and engage in sexual expression”; to access material with sexually explicit content; to have access to “facilities, most notably private space, in support of sexual expression”; to access professional counseling related to sexual expression.

“A good relationship with any person is almost better than any medicine,” comments Nelson Burrous, director of Resident Support Programs. “Riverdale has the attitude that if you as a senior are interested in intimacy and closeness, let us support you in that as long as it’s consenting and no harm is done.”

To this end, the bill of rights encourages staff to help elders find the resources and privacy they need, and commits the Home to helping make such arrangements: a private room for one member of a couple, for instance, and regular sensitivity training for staff. Key to this policy, says Burrous, is the understanding of sexuality as a “right,” not a “behavior.” The Home’s attitude is “How can we support them?” rather than “What can we do about it?” And the Home hopes to help other residences replicate its work with a soon-to-be-available training video and manual.

Such a policy sometimes makes for tricky ethical and personal situations, Home executives admit. Staff who for religious or personal reasons are uncomfortable helping arrange for private rooms or other facilities, for instance, may be excused from these responsibilities. In cases where the elder is cognitively impaired, a designated family member may be called in to consult. What happens if an elderly man thinks the woman he is involved with is his wife, when in fact she is not? Sometimes, says Burrous, the families want the couple separated, and the Home supports that; other times family members want their elder relative to be happy, even if the person doesn’t realize the nature of his or her mistake. If a man believes that the woman he is involved with truly is his wife, Burrous says, it may be too traumatic to separate them.