We just placed my father into an assisted living facility. He is being promiscuous with another resident. How can I get him to stop?

"How can I get him to stop"?
(from the original question)

Medication (reduce urge) +
Staff supervision +
Staff intervention.

Has Shawn been back to say if they have heard anything new? Or from the other family? This has really devolved from answering her actual question to a repetitive blasting of each other on things that yes, no one is ever going to change anyone else's minds, so could we just get on with getting on with it, and stop harping on the "rules and regs" stuff? we all see both sides, we pick the one we agree with, and yet it goes on and on,,, respect for each other on here seems to be going down the drain.

Folks, there’s a difference between a Mr s who is masturbating in public or walking into missus’ rooms with a naked erection, and a Mr S whose had mrs s as a dinner date holding hands and then they’re in bed soon after. The latter is an ordinary behavior among ordinary people, which normally isn’t discouraged.

Not sure if it's been mentioned here (I didn't read every single post), but for those saying just let them be, the female likely will get a UTI, and that may make her spiral down in her dementia even faster, as the caregivers and doctores may not pick up on it right away....so there may well be a negative impact to her by "letting them do what they want".

The discussion of whether its appropriate or not is quite interesting.

I'm no expert , but I would think this - if both residents are competent adults, including competency to consent to sex, then it is 2 consensual adults.

If not, for either or both of the residents, then is'nt it kind of similar to , two underage kids having sex?

I have a question. Can a facility decide on their own to administer drugs to diminish a person’s sexual impulses or do they need the family member’s permission to give drugs to a resident?

This is one activity that can keep them "entertained" for a little while, besides doesn't this fall under the humans are social beings area?

WOW assisted living should KNOW that people with dementia have an arounded sex drive. It is part of the disease. I would made sure they know it is not fair to you, or your father to find another place. It takes two. Perhaps a separate wing. Sorry. My mom who always lived a very faithful Christian life, began talking smack. That was NOT her but the disease. We had a "meeting". I was appalled that the DON was so ignorant to this fact. Heck 50+ years ago, I witnessed this as a nurse aid. You would think people who were professionally educated in geriactrics would know thee things. I would have a sit down and ask for their education and experience. They need to do better.

wow a lot of deep discussion on this topic. I have not read it in full and wont give an opinion, as for my Dad its the complete opposite scenario and this would never happen , so I have no experience.
He has actually been seated at dinner/ lunch with a couple of women and eventually, they both asked to be moved away. With his chauvanistic and mean narcisistic tendencies, managed to scare them both away from even dinner conversation. (now trying to get him seated with some men).

Inappropriate sexual behavior is rather prevalent in dementia patients living in care homes. Here is an excerpt from my book, "Dementia Care Companion" on the subject:

Sexual Behavior in Nursing Homes
Most of the research into inappropriate sexual behavior has focused on nursing homes. Their findings and solutions, however, are equally applicable to patients living at home.
·        Drug-based interventions are more prevalent at nursing homes because of their ease of use and a shortage of trained staff. However, care-based interventions are often more effective at helping with behavioral problems, including sexual issues.
·        In nursing homes, it is recommended that patients reside in single rooms. The ladies’ and men’s wards should be separate and on different floors, and served by female and male staff respectively. TV programs and print materials should be controlled for content that may be sexually arousing.
·        Tell the patient when a particular behavior is inappropriate. If a male patient enters the room of a female patient, gently direct him to his own room, and say something like: “Gentlemen should not enter ladies’ rooms.”
·        Educational interventions, including explanations, are less likely to work with dementia patients, however. Memory problems make it difficult for dementia patients to learn and remember, while impaired reasoning and impulse control make it difficult for patients to follow your logic or redirect their behavior.
Managing Sexual Behavior
Reduce inappropriate sexual behavior by anticipating it and redirecting the patient. In both these areas you have a significant advantage: you can see farther into the future than the patient and can hold on to a thought or a strategy longer than they can.
·        Distracting the patient remains one of the most effective tools in helping with behavior issues. This is especially true for sexual behaviors, as a hard and fast refusal, and the resulting feelings of rejection, can trigger a more angry or violent response.
·        The patient may approach strangers in a store or at a park, and act in an inappropriate manner, like hugging them. To prevent this, always place yourself between the patient and strangers so you can intervene and redirect as necessary.
·        Watch for urinary tract infection and constipation. These conditions and their resulting discomfort may attract the patient’s attention to their genitals, creating the impression that the behavior is sexually motivated.
·        If the patient tends to reach down their pants or take their clothes off at inappropriate times, make it harder for them to do so by having them wear closed-front or one-piece clothes.
Dealing With the Stigma
Inappropriate sexual behavior can be especially embarrassing for the caregiver or other members of the family due to the stigma associated with it.
·        Remember that inappropriate sexual behavior is a consequence of dementia, and not the result of some moral failing or character flaw on the part of the patient, or a shortcoming on your part as a spouse or partner.
·        Educate yourself about changes in sexual behavior and the evolving sexual needs of the patient. A better understanding of the changes helps to reduce the stress of dealing with them. It can also help prolong intimacy between partners, sometimes well into the course of dementia progression.
·        Discuss the patient’s sexual behavior changes with their doctor, and get practical advice on how to deal with them. People often hesitate to discuss sexual issues with their doctor. As a result, problems with sexual behavior tend to go unresolved.

I am shocked that some of you are actually making arguments for why people (who by the way, have to be in a locked care facility under supervision 24 hours a day because they are so out-of-it that their day to day lives cannot be managed outside of a secure facility), can give sexual consent to another person.

These same demented people who are no longer allowed to live in their homes, drive their cars, or have access and control of their own money because of diminished capacity and dementia, still somehow possess enough mental capacity to give consent for someone to have sex with them.

They aren't allowed to choose what they get for supper, but can consent to that.

It's pretty disgusting that some of you are actually looking up court rulings in favor of the demented being allowed to give sexual consent.

In general , perhaps living in memory care would be more suitable since he can’t remember what you tell him .

https://www.verywellhealth.com/should-people-with-dementia-have-sex-4156679

There has already been a court ruling that dementia patients can consent.

Here’s the issue…. It’s going to be quite difficult to clearly establish that it was consensual if it’s known that at least 1/2 of couple has memory & recall issues as he cannot “remember a whole conversation from an hour ago”.

If the lady’s family want to make this an issue, they can. The POA can contact the police to file suspected rape report, they do not need to tell the AL in advance of this. They can contact APS to report that they believe a resident “took advantage of a vulnerable adult”. If their mom / Auntie / grandma has lived there without any hint of sexual escapades happening, the default is the new person caused this. And it is going to be a complete nightmare for the Assisted Living to deal with if either law enforcement or APS get involved.

Other residents already know that something has happened and told their families. Staff is taking about it. Right now as I type this we have 39 different viewpoints on this just on this forum…. the same thing is going to happen within that AL and add to it that there will be petty rivalry and dementia enmeshed within the stories told. If the Dad is a “well respected….financially well off” so he’s fairly well known in the area, this will become hot gossip. The OP and any siblings need to get out ahead of this and asap… and have the dad get evaluation for some type of behavior mod, otherwise that dad will be toast on ever getting into any other place other than a long term behavioral health facility. .

The Assisted Living cannot let the place become Assisted Loving.

https://theconversation.com/seniors-have-a-right-to-express-their-sexuality-in-long-term-care-homes-but-staff-need-guidance-158485

There are a lot of comments here that dementia patients can't give consent. Can you prove, at the time they had sex, that they were not able to give consent?

Dementia patients can sign and have notarized documents if they're aware of what they're signing and its repercussions at the time of signing. They may not recall two minutes later, but at the time they were aware.

Everyone, wait. How did we get to everyone crying rape when OP said nothing about either participant being forced? are we pathologizing dementia patients for carrying out normal dating behavior that normally results in sex?

You have got to GOT TO get out ahead of this and this means dad sees a behavioral health specialist Or geriatric psychiatrist ASAP for an evaluation. Probably in patient facility. Call his PCP to get names.

“how can we get him to stop?” You can’t. And before this goes further and really becomes beyond super problematic (the family of the lady involved file rape charges against your dad and he will be toast on ever getting into anything but a long term psch / behavioral care facility), he needs to be seen by a MD that deals with behavioral.

Adding to this predicament is that it’s Assisted Living. & they are not at all set up to deal with a resident needing observation for non threatening dialysis behaviors and introducing new drugs
Your Dad sounds like he is not at all competent and cognitive; he’s not suitable for Assisted Living, that was a mistake for you and your family and the facility.

The old rooster is not a NH aka a skilled nursing facility but AL. Assisted Living means the residents still have the ability to do self determination, that the reason why they are in an AL is that they need some help, some assistance with their ADLs / activities of daily life. Having consensual sex can be viewed as a ADL. Residents do not need 24/7 oversight. An AL can - and usually for an extra fee- provide for medication management for regularly scheduled RXs or OTC drugs (like Zyrtec) but they usually do not do medication monitoring (like the introductory of a new med and watching it to see if side effects, or the staff giving black box warning drugs) as that’s skilled care.

The next issue becomes… was it consensual? AL is probably beyond very super worried that the ladies family will file a police report that their mom was raped at their lil AL facility. RAPED.
That filing will be a known, this is local news worthy type of reporting. He can be arrested. So much for well respected life, you can forget about that.

You have got to - got to - get ahead of this and have him seen by an MD or a clinic that does behavioral health. It will more likely be in patient type of placement while his medications and therapy are tweaked. And then he’s hopefully assessed to be ok for going into the MC sector of a NH/SNF, so he has 24/7 oversight. You are fortunate that your Dad has the $ to pay for this as it will be costly.

From the other answers here, it sounds as if your father is removed from this facility, he will probably have the same problem in another facility unless some of the interventions others have mentioned are made and are effective. I am surprised, though, that all the other facilities you've looked at are "much worse." I've told my family(assuming I am unable to place myself) that I didn't want to be in a place with bedbugs and lots of roaches, but if I didn't know what was going on, not to use my money for the best possible place. (I will be self-pay if/when this happens.) Are you sure your father will notice a difference if he's not in the best place? I of course don't want you to have to move him, and it well may not do any good if yo're forced to do so, as discussed, but try not to be so concerned if he needs to go to a lesser place as long as he gets decent care.

Dylan
I worked as a Marketing Director in the senior care industry - all levels of dementia / memory care, active 55+, independent living, and assisted living for about 15 years. I’m dementia certified as well. I’m surprised the staff indicated he may have to leave the community because he’s having sex with another dementia resident. Believe it or not, it’s actually normal. I’m saw this happen daily with many residents. Although not the #1 demographic, the senior population has one of the highest reported cases of STD’s. They do become more promiscuous especially those diagnosed with dementia. Google it.

The Executive Director or nurse at the community is required to report it to both families which appears they did so no issue there.

You are correct in assuming that if you spoke to him about it ,he’s not going to remember ( if more advanced) and even if he did, I’m sure he wouldn’t care or stop demented or not - just being honest.
I’m not sure why the nurse is so bothered by this. I question her / his knowledge with dementia and common behaviors associated with it. Just because s person has dementia , doesn’t mean the desire for intimacy is automatically removed. Nor does a person automatically or immediately lose the capacity to consent to sexual activity upon diagnosis. There’s also several stages of dementia.

Research points to the many benefits of touch for people with dementia, and healthcare professionals have emphasized the importance of person-centered care in dementia. Some facilities have written policies on recognizing the physical, emotional, mental, spiritual, and sexual needs of those in their care available for you to read.

I see a lot of comments about consent. Several things should be considered centered around
“ consent” and indicators around that…
 

Recognition: Does each person consistently recognize each other? Do they know the name or room location of each other? Does one person mistakenly think the partner is her / his spouse when he's / she’s not?

Interest: Do they both seek each other out consistently?

Verbal and non-verbal communication of emotion: What do their verbal and non-verbal communications say? Does each person express a desire to spend time with each other?

When you observe them interact, are both engaged with each other and appear happy? Can they answer questions about their relationship and indicate a desire for physical intimacy?

Ability to say "No": Does either person display any signs of distress, such as emotional withdrawal, fear, tearfulness, decrease in appetite, or physical recoiling from touch? Are both people able to say "No" (verbally or non-verbally) to unwanted sexual contact?

Can each person indicate "how far" they wish to proceed with sexual interaction? For example, is one person content with kissing and touching, and the other attempting to progress to more intimate activities?

Effect on quality of life: Does the relationship appear to improve the quality of life for both people?

If there appears to be no issues, let them be.

It takes less than three weeks from the first kiss or even holding hands to getting naked for many people. How can anyone fault dementia pts for doing what is more or less typical for the general population?

If they seem happy to be together / enjoying their time … why stop them? My goodness, by the time dementia is advanced enough for memory care - why deny them whatever friendships or relationships or pleasures they can find in their MC environment.

Shawdogpro: Perhaps he can be relocated to a different area of the facility. OR he requires memory care residency.

Our state allows cameras in rooms. A picture is worth a thousand words. I see cameras as a useful tool, not an invasion of privacy.

Let’s face it, cameras are everywhere. The only people that are bothered by cameras are people who have something to hide. We put cameras in daycares because children should be protected. Our elderly should be protected also.

I wouldn’t rely on hearsay about what was going on if someone didn’t see what occurred from the beginning.

If the residents have dementia, the facts may be distorted.

These things should be discussed before a family member moves into a facility.

Occasionally the topic will be raised by the person giving the tour of the facility.

I toured a few places that I was considering for my mom. The head nurse led me on the tour and brought up this topic

She said that some residents do hold hands or hug throughout the day because they considered themselves to be a couple.

She also added that at the end of the day each resident went to their own rooms separately because they didn’t allow them to sleep together in the same room.

Is this actually enforced? Who knows? That’s why I would have a camera installed in the room.

There are stipulations about having a camera in a resident’s room here. The camera can only be placed on your family member. If they share a room with someone, you cannot film the roommate.

He still has it lpl There's a woman in the facility flirting with a few male residents, even having a jealous one.

In most facilities I do not think they have regulations prohibiting this.
If he is "forcing" himself that is a different story.
If the two are "companions" and acting as a couple I do not see a problem. (more on that later)
I realize both have dementia so "consent" is sort of out of the picture but you can tell if advances are forced or unwelcome. If that is the case then I can see where they would ask one or the other to leave, or if there is another MC wing a move to there would be an option.

Now is dad actually having intimate relations? If so next Dr appointment as embarrassing as it might seem ask that he be tested for STD's.

As humans we all crave a touch, a hug, an embrace. It is nice to be able to have the comfort of another person. Unfortunately many elders are missing that even from family caregivers we stop touching in a kind gentle way, we touch as a means to get a job done, a soiled brief, a bath, getting someone dressed. We don't touch a shoulder, we don't rub a back.

I posted early on in the thread about asking the doctor about meds. That would be the first thing that I would do in this situation.

Anyone care to comment on the rise of STDs in facilities? This topic alone would cause me to be concerned about the sexual activity that occurs between residents.

This must be very stressful for you and the lady's family. Dementia manifests itself in terrible ways, in uncomfortable ways, and in dangerous ways. First, to all those saying leave these "couple" alone and let "romance" happen, this is not a romance, nor is it between two healthy, consenting adults. Second, "well off financially" to one person means either "wealthy" to some people and "prepared financially to take care of one's self in old age" to another. The fact that you knew that you could no longer care for him shows you are responsible and caring to your father, enough so that you found the best place for him to live. That is a good thing. In the three weeks he has lived in this home (I do not know what kind of place it is - AL, memory care, nursing home?), he has already found a woman with whom he went to bed. That already shows very bad decisions and lack of personal control. I agree with the person that said he needs to see the doctor and these issues need to be addressed. If he is living in an AL (which is not an appropriate place for someone in his condition, IMO), then he should be switched to a more controlled situation. Assisted living is for adults who need some help with day to day care, but are no danger or problem to others (or themselves) living in the AL. Your dad cannot help what is happening to him, but his behavior is affecting others and could be considered a danger to others. He needs expert help and medical help, and there is no such thing as a consenting adult where dementia is concerned. Between you, your family, the doctor, and the people in charge of the place where he lives, there should be some plan of action, not just some nurse spouting off about "removing him". This requires a meeting of the minds between you and those whom you pay (dearly) to be experts in taking care of your dad. I wish you good luck and know that you and your sister are doing the very best you can for your dad, and if he were in his healthy mind, he would know this, too.

This subject always causes an argument here.

Your father needs Memory care. ALs are not set up to "watch" residents. I am surprised Dad was excepted. They assist. They are not babysitters. Some people in ALs have cars. Its like living in an apt but someone there to help when you need it. Ex: you can get a shower by yourself, but u need some help getting in without falling. I know a woman who was living in the AL because of her husband. He passed, she chose to stay.

I agree with Burnt, those with Dementia cannot make a decision to say yes or no. I am very aware it happens but where do u draw the line. Maybe the woman did not consent just is in shock. Personally, the only old man I want touching me is my DH. My Mom did not like men once Dementia set in so I am sure she would never have consented.