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Staff attitudes towards sexual relationships among institutionalized people with dementia: does an extreme cautionary stance predominate?

Published online by Cambridge University Press:  13 December 2013

Feliciano Villar*
Affiliation:
Department of Developmental and Educational Psychology, University of Barcelona, Barcelona, Spain
Montserrat Celdrán
Affiliation:
Department of Developmental and Educational Psychology, University of Barcelona, Barcelona, Spain
Josep Fabà
Affiliation:
Department of Developmental and Educational Psychology, University of Barcelona, Barcelona, Spain
Rodrigo Serrat
Affiliation:
Department of Developmental and Educational Psychology, University of Barcelona, Barcelona, Spain
*
Correspondence should be addressed to: Dr. Feliciano Villar, Department of Developmental and Educational Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain. Phone: +34 933125860; Fax: +34 934021368. Email: fvillar@ub.edu.

Abstract

Background:

This study explores whether staff perceptions and reactions to sexual situations involving one or two persons with dementia (PWD) reflect an extreme cautionary stance (an overprotective and paternalist style) or a person-centered model of care (focusing on understanding the residents’ perspective and their rights).

Method:

Fifty-three staff members currently working in residential aged care facilities (RACFs) were purposively selected to participate in the study. Two vignettes describing sexual situations involving PWD were presented to participants. They were asked about their interpretation of the situation and how they would react. Data were analyzed using content analysis, aimed at identifying common themes in the responses.

Results:

When the sexual relationship involved a PWD and a cognitively intact resident, participants tended to define the situation as real (54.7%) or possible (35.8%) abuse, whereas when both parties had dementia it was more frequently conceptualized as a possibly abusive (39.6%) or non-abusive (37.7%) situation. The most frequent reaction to both situations was seeking the advice of other professionals.

Conclusion:

The interpretation of the first situation is compatible with an extreme cautionary stance, whereas the second scenario is less clearly perceived as an example of abuse.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Aizenberg, D., Weizman, A. and Barak, Y. (2002). Attitudes toward sexuality among nursing home residents. Sexuality and Disability, 20, 185189.Google Scholar
Alagiakrishnan, K. et al. (2005). Sexually inappropriate behaviour in demented elderly people. Postgraduate Medical Journal, 81, 463466.Google Scholar
Archibald, C. (1998). Sexuality, dementia and residential care: managers report and response. Health and Social Care in the Community, 6, 95101.Google Scholar
Brooker, D. (2004). What is person-centered care in dementia? Reviews in Clinical Gerontology, 13, 215222.Google Scholar
Burgess, A. W., Dowdell, E. B. and Prentky, R. A. (2000). Sexual abuse in nursing home residents. Alzheimer's Care Quarterly, 38, 1018.Google ScholarPubMed
Cotrell, V. and Schulz, R. (1993). The perspective of the patient with Alzheimer's disease: a neglected dimension of dementia research. The Gerontologist, 33, 205211.Google Scholar
Di Napoli, E., Breland, G. and Allen, R. S. (2013). Staff knowledge and perceptions of sexuality and dementia of older adults in nursing homes. Journal of Aging and Health, 25, 10871105.Google Scholar
Edvardsson, D., Winblad, B. and Sandman, P. (2008). Person-centred care of people with severe Alzheimer's disease: current status and ways forward. The Lancet Neurology, 7, 362367.Google Scholar
Ehrenfeld, M., Bronner, G., Tabak, N., Alpert, R. and Bergman, R. (1999). Sexuality among institutionalized elderly patients with dementia. Nursing Ethics, 6, 144149.Google Scholar
Hashmi, F. H., Krady, A. L., Qayum, F. and Grossberg, G. T. (2000). Sexuality disinhibited behavior in the cognitively impaired elderly. Clinical Geriatrics, 8, 6168.Google Scholar
Holmes, D., Reingold, J. and Teresi, J. (1997). Sexual expression and dementia. Views of caregivers: a pilot study. International Journal of Geriatric Psychiatry, 12, 695701.Google Scholar
Johnson, C., Knight, C. and Alderman, N. (2006). Challenges associated with the definition and assessment of inappropriate sexual behavior amongst individuals with an acquired neurological impairment. Brain Injury, 20, 687693.CrossRefGoogle ScholarPubMed
Lesser, J. M., Hughes, S. V., Jemelka, J. R. and Griffith, J. (2005). Sexually inappropriate behaviors. Assessment necessitates careful medical and psychological evaluation and sensitivity. Geriatrics, 60, 3437.Google Scholar
Mahieu, L., Van Elssen, J. and Gastmans, C. (2011). Nurses’ perceptions of sexuality in institutionalized elderly: a literature review. International Journal of Nursing Studies, 48, 11401154.CrossRefGoogle ScholarPubMed
Pillemer, K. et al. (2011). Resident-to-resident aggression in nursing homes: results from a qualitative study. The Gerontologist, 52, 2433.Google Scholar
Owen, W. F. (1984). Interpretive themes in relational communication. Quarterly Journal of Speech, 70, 274287.CrossRefGoogle Scholar
Roach, S. M. (2004). Sexual behavior of nursing home residents: staff perceptions and response. Journal of Advanced Nursing, 48, 371379.Google Scholar
Shinoda-Tagawa, T., Leonard, R. and Pontikas, J. (2004). Resident-to-resident violent incidents in nursing homes. JAMA, 291, 591598.Google Scholar
Tabak, N. and Shemesh-Kigli, R. (2006). Sexuality and Alzheimer's disease: can the two go together? Nursing Forum, 41, 158166.Google Scholar
Tarzia, L., Fetherstonhaugh, D. and Bauer, M. (2012). Dementia, sexuality and consent in residential aged care facilities. Journal of Medical Ethics, 38, 609613.Google Scholar
Vaismorari, M., Turunen, H. and Bondas, T. (2013). Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15, 398405.CrossRefGoogle Scholar
Ward, R., Vass, A. A., Aggarwal, N., Garfield, C. and Cybyk, B. (2005). A kiss is still a kiss? The construction of sexuality in dementia care. Dementia, 4, 4972.Google Scholar