Love Endures

When Love Strikes

Safety is on the mind of the staff at one of the homes run by Cedar Creek Associates in suburban Maryland. There, two elderly residents mistakenly believe they are married and deserve all the privileges of matrimony.

Because the residents have dementia, Karin Lakin, one of the Cedar Creek directors, met with the families of both to make sure they were aware of the relationship. She has also called staff meetings -- including one where she showed Reingold's video -- to discuss the relationship. Whatever their individual views about sex, she reminded the staff, they must abide the home's open-arms policy and, if they walk in on the couple at an inappropriate time, simply come back later.

Some staff members voiced concerns.

"I don't like seeing him on her because she's not young anymore," said one middle-aged female employee. Another worried that the man had been displaced from his own bed by his woman friend and left to sleep in a recliner. Lakin listened and reassured her staff the best she could. The man, she explained, chose to sleep in the recliner -- something to which he had become accustomed when he cared for his sick wife. She remained confident, she said, that the couple was safe.

To make a freedom-of-sexual-expression policy work, the level of freedom can't exceed the level of supervision, says Reingold, since dementia patients can't be expected to protect themselves from unwanted advances. Also, the risks associated with sex -- from getting a sexually transmitted disease to hurt feelings -- transcend age or mental well-being.

"We are creating an environment that encourages relationships . . . because relationships lift loneliness, despair and depression," said Reingold. "But while we are doing that, we have to protect the people who don't want to be touched or can't make decisions."

Residential facilities are also legally bound to protect their residents' rights to privacy. Doing so may mean not telling families exactly what goes on in the bedroom, assuming the resident is what Reingold calls "oriented."

"A person may not remember what they had for breakfast, but they know they are in love with that woman -- they may not remember her name, but when they get up in the morning, they want to see her," he said. To the family, "we wouldn't say they have sex or whatever, but that they are having a relationship," said Reingold. If the family members want more information, they can ask the resident.

Families' Responses

Despite the equanimity shown by family members in Reingold's video, reactions of families they encounter are quite varied, care managers say. Some feel they must protect their loved ones from doing things they wouldn't have done in their pre-dementia days; others are happy to see new relationships blossom, at least to a point.

For example, two Northern Virginia nursing home residents, who both had dementia, were dating, at separate times, an 85-year-old male resident who was in full command of his mental faculties. During meetings with the facility's director, the children of both women nixed the sex, the man's son said. One family forbade the man from ever seeing their mother again.

That woman moved to another floor. But the second woman remained nearby. "I had to have a talk with my dad, explaining that he can't be hitting on this lady," the son said. The father was sad and indignant, but he complied.

Lakin said relationships among residents can be a bigger issue for the families involved than for anyone at the facility. Workers at one of her group homes smile at the idea of trying to stop residents from pairing up. "How?!" one staff member asked. "Maybe the families need training!"

Institutions will definitely need more training in how to handle intimacy among residents when the next generation of old folks moves in, Reingold warned. Aging baby boomers and retired hippies -- the creators of hip huggers, thongs and, yes, free love -- just may be a little less inhibited than the current generation, he suspects.

Which is to say the next sexual revolution may occur not on the muddy fields of Woodstock or the back of a VW van, but on the clean, crisp sheets of your local nursing home. The mind reels.•

Tina Adler is a Washington area freelance writer.