Personnel working in Quebec’s long-term care centres should be trained on discussing sexuality with residents who express a need for a romantic of sex life.
It’s one of the recommendations from a report published this week that Marguerite Blais, Quebec’s minister for seniors, has received favourably. Her press attaché, Jean-Charles Del Duchetto, said it was a first of its kind and “a new policy should be unveiled by summer.”
He said long-term care homes (CHSLDs) were not designed with romantic or conjugal lives in mind.
“Society evolves, so the housing of seniors has to evolve as well,” he said.
Blais asked the Comité national d’éthique sur le vieillissement to produce a report taking into account the reality on the ground and issues that neurodegenerative diseases can create in terms of consent.
Can people with Alzheimer’s disease, dementia or other cognitive issues give informed consent?
For Dr. Sophie Zhang of the CIUSSS Centre-Sud-de-l’Île-de-Montréal, there are some clearly capable of expressing consent and others who are not. The ethical challenge is with those between those two categories, in a grey zone that many patients are navigating.
“We’re very familiar with consent in CHSLDs.” said Zhang, who is responsible for 15 CHSLDs.
She said each case is unique. Some people will hold hands, others will go further. Staff pay particular attention to signs that could indicate a person is uncomfortable.
It can happen that the team has to inform the family. “Most times, it goes well,” she said. “We had one person who was in a relationship and made a new friend in residence. We contacted the family to tell them that she showed physical affection toward another person. The husband and the family were understanding.”
Zhang said they understood that it wasn’t malicious, and the resident probably forgot she already had a husband outside the walls of the centre, because of the disease.
The report also recommends creating private areas in residences, which often have residents where the partner lives elsewhere and people often live in shared rooms.
Zhang was favourable to the idea of designated rooms. She said that ideally “if everyone had a private room, soundproofed with a closed door, they could have intimacy.”
She said she hopes Quebec is headed to a future where CHSLDs no longer have shared rooms. “It will be better for everyone for all sorts of reasons,” she said, including improving health care and preventing infections.
Zhang said we must break down the myth that seniors don’t have a sex life, while noting that others don’t consider it important.
Sexologist Mariane Gilbert agrees. “If your sex life has always been important to you at 30, 40, 50 years old, it will still be the case at 60-plus,” she said.
Zhang said it’s important that staff be trained to respond to residents’ questions. That would require experts and sexologists who can give that training. And we must also consider the sexuality of people living alone in this discussion, she said, noting situations in which her team has, for example, surprised a resident in the middle of self-pleasuring.
This article was produced with the financial assistance of the Facebook and Presse Canadienne News Scholarships.