The elderly man that I care for asks me every day and very directly to perform sexual acts on him. I have tried everything I can think of.

Well, the actual client is a lady in her 80s. The OP is her lead caregiver, and also co-ordinates a team of caregivers in the home.

So who is engaging in inappropriate behaviour, and towards whom, and what has happened exactly?

Do you work for an agency?

The number of people who need care far exceeds the number of caregivers out there. The papers are full of ads for caregivers and agencies and families are practically begging for good caregivers. Tell whoever you work for, be it an agency or this man’s family, that you have too much self-respect to continue working with this man. When you do get another job, since this is your second “charge” who seems obsessed with sex, pay particular attention to what you say and your actions. You do not want a repeat of your last two experiences.

Its not just an issue of self respect, it a legal one of sexual harassment and further. Put in context if another employer, you could damn well contact the EEOC. Spoken from perspective of assault advocate. Document all.

Just because someone is old does not , DOES NOT, excuse this. By any means. This is the hidden #me too.

I am going to contact you privately. But you need to document in graphic detail what he is asking. Dates. You need diagnosis. Medical on letterhead. Resign from this.

It is affecting more than you can state here. I know and will leave at that. I sent you a Pm.

A private message.

I am starting a separate thread on private caregivers and what you have had to deal with. Because often , private, despite costs, are asked to deal with most difficult. It would be good to hear your side.

Just an aside here. I commend you for asking your questions. This can't be easy for you. Thank you for asking.

Oh blimey.

Well, you're the professional! Normally we'd be asking you for advice... :/

To the middle-aged amateur, e.g. me, it sounds like short-term you've got two options.

1. Adopt a Nurse Ratched strategy.
2. Subcontract male personal caregivers.

In the wider context though, it's actually quite an interesting ethical question.

Possibly not one I'm very comfortable discussing, as it turns out!

But. This is a man whose interest in sexual activity has not waned but who is unable, unaided, to gratify it. What to do?

He is not free to pick on the nearest available breathing female, no. Obviously not. Have you discussed options and possibilities with your professional peers? I'm sure there will have been research and debate, and personally I can accept that this should be an aspect of care that's as important to wellbeing as hygiene and nutrition, but I freely admit that I have no clue what you do about it.

Any family members or professional representatives of his that you can consult?

Get out! Not worth it. Report it.

If you work for an agency, you can ask advise from your co-workers and supervisor on the SOP for this situation. My dad also suffered a stroke, left side was very weak and completely bedridden. Unfortunately, he was always .. uhm … 'flirty' with women. Having the stroke just made him bolder, less social restraint. Towards the end, he was quite vocal (sexual content) when the visiting caregivers came to sponge bathe him in bed three times a week. They reported to their supervisor that they were afraid of him. These caregivers were new on the job and had no real experience on how to handle the situation. Supervisor called me and we spoke. I lectured him. I gave the supervisor permission to call later on and to also talk to him about the seriousness of the situation and the consequences. And I had to make sure a family member was in the room when they were sponge bathing him.

If you're a private caregiver, I recommend you watch a lot of YouTube videos or other research on how to handle a difficult client. The few times I was home when the caregivers came, I saw how they handled my dad.
1. They joked back to him in the same vein - which I did not feel comfortable with. But obviously outwardly, they did.
2. They sternly corrected him and then changed the subject - usually something that's funny.
3. They ignored his comments and changed the subject.

Overall, from watching them, it was using distractions that got my dad to laugh.

When a person has a stroke it can damage their brain in a way that they become completely sexually uninhibited. I experienced this with a close family member.

The inappropriate behavior from my (formerly extremely prim/private/proper) loved one ranged from mild to outrageously inappropriate statements and inappropriate to extremely embarrassing conduct. As you can imagine, it was painful to watch this horrifying behavioral/personality transformation with a loved one.

Apparently this brain injury is fairly common with stroke patients. In an effort to help improve my loved one’s situation, I discussed this with many doctors. The doctors told me this would likely be the “new normal.”

As with any severe brain injury, the situation could improve slightly with time and healing. It did improve slightly for my family member, but not completely.

Understand that as this man’s brain is damaged, he no longer has control — don’t take anything he says personally. Please don’t judge him or his family. He simply can’t help it.

I had to grow to accept this - but you don’t!

The good news for you is you are not a family member! You have the choice to leave and should if this behavior is intolerable to you in any way.

What I see here is he had a massive stroke. It could have effected "that" part of the brain and his ability to filter. Was he a "dirty old man" before his stroke? Really, I think reporting him for harassment is a lost cause when you figure he is a stroke victim.

But I would document it and tell whoever is in charge of his care he needs some type of intervention. Meds, LTC. If not, they are going to lose aides right and left. Maybe they should see if there are men who can do the shift he needs to be bathed. My daughter has male CNAs at her job.

It sounds like the cousin has had to replace caregivers once or twice before, huh...

Unless the cousin is so terribly elderly and prim that you really can't face it, I wonder if it would be worth making him concentrate and saying okay, let's cut to the chase with this and stop messing about: your relative is highly sexed and it's making him not just a pest but a sexual harassment suit waiting to happen. What are the options?

One option, I have no idea whether it could be done legally or not, might be the obvious. If the gentleman was in the habit of accessing sex workers in the past, for example, could there possibly be a way of finding out more about his preferences and organising visits?

I myself find this more embarrassing than incontinence so I wouldn't blame you if you did too. But on the other hand I am quite sure he wouldn't be the only very elderly gentleman on a reputable escort agency's client list. Maybe he already is.

I think you need to know what the cousin knows. You obviously can't hire hookers for your client, but if it's legal in your state could he?

He may not have dementia but he could have other neurological issues. You did not say if he has relatives for you to inform them, so i think you may want to ask him who his doctor is and alert the doctor of the strange behavior. Healthy people do not act this way.

No way would I put up with this--ick. He's not going to change; there's nothing you can do. I'd get out right away--you'll have your pick of other jobs. Take care.

Would the cousin be willing to pay for a male caregiver to be hired to come in just for bathing purposes?

Are you sure there is no dementia? Yes or no, I would speak to the family to see about having a sexual surrogate visit him to see if this helps. Is there anything hormonal going on? If he has unmet sexual needs, shouldn't these needs be addressed?

Tell him in a straightforward way that his behaviour and language is unacceptable and harassment, and that if it is repeated you will simply leave. Then next time he does it pick up your bag and walk out. Now you may have to warn any agency you work for that this is what you are going to do, but if they do not support you then you have an employment issue with them, but they should do. Unless he cannot be left alone for even one minute nothing drastic will happen if you walk out, and if you have warned your employers then they can have someone on standby to take over from you in whatever time they feel it necessary to get someone to him. Don't put up with this.

Quit.

Problem solved.

Just reviewing some of your replies.

If he can walk with a walker, he can use a wet room, or even a shower chair or even a bath cushion at a pinch, and he can wash himself. Who px'd the bed baths three times a week?

Also - you've probably already tried this - what happens if there are two caregivers present during bathing routines?

Judyscare: Dementia aside, he may just be a dirty old man. I would warn him and if he persists, I'd leave the perv to his own devices.

What this man is doing is called sexual harrassment. He can, and should, be reported to the police.

I would be direct with him since there is no dementia. Tell him the conversation makes you uncomfortable and if he doesn't drop it, you will have no choice but to find new employment. What he is doing is abusive and you should not put up with poor behavour.

Seems he is not going to change.
Suggest you consider finding another position and that the cousin get a male caregiver to care for him.

This can be a tricky situation as your safety and his is the first priority.
You need to establish yourself as the Professional that you are! State honestly that you are there to provide support for him. The sexual advances are unwanted and unexceptable. You may have to excuse yourself as a professional from this case. Be honest with him non threatening and kind.

I highly recommend you get out, stop caring for him right away! If he is competent and doing this who know what he may try accusing you of down the road.

Tell the family to get him a male caregiver!

He is making you very uncomfortable and he must know it if he doesn't have dementia. So I don't think he would respond to nice. I doubt he will stop. You need to get away from him..

Find another job!!!