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College of Health and Human Sciences

Gayle Doll writes book about sexual expression in nursing homes

Monday, March 12, 2012

The professor stood in front of the unconventional class at a retirement community and asked: “What would you have done differently if you had known you might live to be 150 years old instead of the 80 years of life expectancy typical for Americans?”

A hand shot up in the front row and an 85-year-old woman said, “I’d have had more lovers.”

College students in the intergenerational class gasped. But Gayle Doll, assistant professor in the College of Human Ecology at Kansas State University and director of the Center on Aging, wasn’t surprised. She was becoming used to frank talk from the older generation.

The author of a new book titled “Sexuality and Long-Term Care” has come to realize that older people aren’t much different from younger people when it comes to sexuality and the need for intimate relationships. But she noticed that when the story involved someone living in a nursing home it was always seen as a problem.

Many nursing homes and long-term care organizations have not had formal discussions about resident sexuality and have not developed policies or staff training to address it, Doll said. She hopes her book, published by Health Professions Press, will pave the way.

“There is a shortage of research on this subject,” she added. Among studies recounted in the book was her research to gauge the frequency of sexual expression in nursing homes.

Doll defines intimacy (and sexuality) as acts ranging from a compliment to sex. Sexual expression can be as simple as getting your hair done to be attractive, not sexually attractive, but feeling like you look good and hearing the words “You look so nice today.”

Physical touch is also very important. “One woman told me she manufactures ways to get hugged,” the professor said. She told the story of a man who said living a nursing home was like being homeless because of the lack of intimacy. He once told a staff member, who placed a hand on his back to guide him, “Thanks you for touching me. It’s the first time I’ve been touched since my wife died.”

Doll sees obstacles in nursing homes that prevent acceptance of sexual expression by residents.

One is administrators and staff. Often a little bit of education will help them create a policy and guidelines to help address issues such as inappropriate places for inappropriate activities and of resident health and safety, Doll said.

At one Kansas long-term care facility, the Center on Aging staff conducted training on sexuality and revisited six months later. “We found staff putting ‘do not disturb’ signs on doors and pushing beds together,” Doll said.

“They were becoming award that each resident is a whole person,” she said.

Another hurdle is the resident’s family.

Doll’s research indicates a wide range of family reactions to sexual expression in a nursing home setting. Most reaction was supportive or indifferent. But 25 percent of respondents were unsupportive and many were angry or embarrassed. One wrote that the family members had been “humiliated” by their mother’s actions, Doll said.

Her advice to adult children: Just because your parents don’t talk about sex doesn’t mean they don’t think about it. Acknowledging the need for sexual expression “honors the person that the older person is now,” Doll said.

For students, it’s a revelation to realize that the elderly think about sex, Doll said.

She called awareness a giant step forward overcoming the obstacles.

One example, she pointed out, was the public story about retired Supreme Court Justice Sandra Day O’Connor accepting her husband’s growing affection for another Alzheimer patient in an assisted-living center. The O’Connors had been married for 54 years; John O’Connor was diagnosed with Alzheimer’s in 1990.

Doll also pointed to the 2007 film “Away from Her” about a couple struggling with Alzheimer’s disease. “The memory of love is present even if one’s memory is compromised,” Doll said.

“Sexuality and Long-Term Care: Understanding and Supporting the Needs of Older Adults” targets those who work with long-term care facilities but can serve as a handbook to others on such topics as staff attitudes, family influences, dementia, inappropriate behaviors, health and policy. She also provides case studies and related activities.

From administrators to state regulators, from care staff to families, Doll wants a change of attitude. Most tend to look at sexuality in long-term care as a problem. Doll sees it as respecting individuals and realizing they need to be able to experience intimate relationships across the life span.

Baby boomers, one of the next waves who will enter nursing homes, were participants in the sexual revolution, Doll noted. Administrators, staff and families need to be ready for them.

Prepared by Human Ecology communications




This article was posted on Monday, March 12, 2012, and is filed under Center on Aging, College News.