Booze, Sex & STDs in Senior Living Facilities

Seniors. They may be living in an assisted living or residential care community, but that doesn’t mean their fun times are over and they’re limited to knitting or watching soap operas. On the contrary, studies show that sexual activity is common in older demographics, as is alcohol consumption.

And what could be an unfortunate consequence of both of these activities—contracting a sexually transmitted disease (STD)—is on the rise, according to a recent study that reveals a growing occurrence of diseases and infections among sexually active seniors.

Some senior living providers might be wondering how they’re supposed to handle behaviors that could negatively impact a resident’s well-being, and it comes down to finding a balance between honoring and supporting an individual’s wishes, and making sure they’re informed and capable of making certain decisions, says Frieda Pulkowski, owner of Cherry Tree Senior Care Consulting.


“The biggest issue I have seen in assisted living and skilled nursing facilities is the conflict between what a family member or caregiver hypothetically believes about how they will respond and how they actually respond when an issue occurs,” she says. “Most people agree that they will support residents’ rights to choose and engage in any behavior as long it it’s not harmful to themselves or others.”

It can be hard for staff at senior living communities to support decisions that don’t align with their own beliefs, and sometimes adult children are unhappy with choices their parents are making that they think are out-of-character, she says.

Basically, the focus needs to be on maintaining a resident’s choice, privacy, and safety, Pulkowski emphasizes, and with STDs on the rise, education is key. This applies to not just the seniors, but also facility administrators who need to be familiar with state laws regarding residents’ rights and establishing that intimacy is consensual.


Rise of Sexually Transmitted Diseases in Seniors

Eight out of 10 people aged 50 to 90 year olds are sexually active, according to research published by the British Medical Journal, and the number of STD cases in that age group more than doubled in the past 10 years.

Between 2000 and 2009, diagnoses of STIs (sexually transmitted infections) in individuals older than 45 doubled to nearly 13,000 cases, the survey revealed.

Recommended SHN+ Exclusives

While seniors have a right to engage in sexual activity, it’s important to make sure they’re aware of possible consequences, says Pulkowlski.

“The biggest piece is education for everybody involved,” she says. “It’s a collaboration between a physician and the facility staff; they absolutely have to provide education [about practicing safe sex].”

Alcohol Consumption Affecting Seniors’ Decision-Making

The same is true for alcohol consumption. While those aged 65 and older are less likely than other age groups to drink regularly, according to the Centers for Disease Control and Prevention, binge-drinking is a growing issue among seniors.

In fact, the 65+ demographic reported binge drinking (i.e. consuming five or more alcoholic beverages) more frequently than any other age group, according to a CDC report. Seniors who binge-drink said they did so 5.5 times a month, compared to an average of four times a month among the other age groups who binge-drink.

In addition to other harmful health effects, the CDC points to excessive drinking as a factor in the spread of sexually transmitted diseases.

“Extensive drinking can cause aggression and lower inhibitions,” Pulkowlski notes. “As providers, we have a responsibility to monitor that, too. If we see someone engaging in behavior that potentially puts them or others at risk, then we also have a duty to intervene.”

Sexual Activity Among Memory Care Residents

Adding another wrinkle to the drama is the issue of memory care patients having sex. If individuals have varying levels of dementia or any sort of memory impairment, it can be difficult to ascertain whether or not sexual activity is consensual and understood.

Pulkowski recommends holding a “care conference” with concerned parties including the residents in question, family members, and staff, and also consulting with a physician.

“We want to honor the resident’s wishes first, but are they cognitively able to know what’s happening? Can we keep them safe?” she asks, adding that it’s especially tricky if a resident with dementia wishes to engage in sexual activity with someone who does not have any memory impairments. In these cases, the provider must verify that the resident with dementia is aware of both the risks and benefits of their actions, has the ability to say ‘no’ at any time, and is not at risk of exploitation.

“It helps to identify what level of dementia the resident hasobviously residents with milder stages are more likely to meet the above criteria,” says Pulkowski. “It also helps to identify whether or not the behavior in which the resident is now engaging is consistent with his or her historically held belief system.”

In general, thorough documentation and discussions are called for, along with a “thoughtful, well-written policy that is communicated to all,” she says.

The study referenced above, “Sexual health and the older adult,” can be read here, and click here to read about how one assisted living community handled sex between two memory care residents.

And if you’re looking for a different sort of take on sexual activity among seniors, check out The Daily Show’s Dirty Bird Special.

Written by Alyssa Gerace