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Does Your Jewish Nursing Home Have a Sex Policy?

Perhaps, not since “The World According to Garp” has the issue of sex in healthcare facilities been in the media so prominently.

In the U.S., National Public Radio broadcast a story last week on whether patients/residents of Jewish nursing homes who suffer from dementia can consent to sex, or sexual intercourse.

The story was prompted by a decision by an Iowa jury last week that found that Henry Rayhon, 78, was NOT guilty of sexually assaulting his wife. She suffered from dementia most likely related to Alzheimer’s disease.

Mr. and Mrs. Rayhon, both widowed, married seven years ago, having met in their church choir. He is a well known lawmaker in Iowa. The criminal case had accused him of sexual relations with his wife last Spring. (His wife passed away at the end of last Summer.). Their son called the case a “witch hunt.”

The staff at Mrs. Rayhons’ nursing home said that because of her illness, she was no longer capable of consenting to sexual intercourse. Also, her daughter from her previous marriage requested that sex not be allowed. Mr. Rayhon was charged with sexual assault for allegedly having sex with her after that.

Dr. John Brady, medical director of Concord Care Center, testified for the prosecution. He stated that Mrs. Rayhons had severe dementia and that any positive reaction to her husband’s affectionate advances were not conscious decisions to reciprocate. Joel Yunek, the defense lawyer, asked whether her hugs, smiles, talk and hand holding weren’t indications of understanding and affection with her husband. Dr. Brady replied, “No.”

NPR turned to the Hebrew Home in Riverdale (The Bronx), NY.

Attorney Daniel Reingold, MSW, the CEO of the group that runs the nursing and care facility told the radio network that, “We knew that there was intimacy occurring [at the Hebrew Home], and we considered it to be a civil right and a legal right. We also felt that intimacy was a good thing, that touch is one of the last pleasures we abandon and lose as we age.” The Hebrew Home has a policy on sexual relations that protects its residents from unwanted sexual contact.

Reingold asserted that those who suffer from dementia are indeed capable of giving consent. He said, “People who have Alzheimer’s disease or dementia are asked on a daily basis to make decisions about their desires, from what they eat to activities they may want to engage in.” And these activities can include intimacy with another person.

A recent study found that only thirty percent of nursing homes surveyed had a policy on sexual relations and only 25 to 30 percent of staff members had formal training in the area of intimacy and sexuality with regard to older adults and patients. Reingold said that this has to change quickly, especially with the arrival of new patients from the baby boom generation – a generation that communicates more openly on the topic of sex.

NPR also interviewed Evelyn Tenenbaum, a professor of law at Albany Law School and bioethics professor at Albany Medical College. She serves on the Ethics Review Committee at Albany Medical Center. Tenenbaum said that even with a written policy, nursing homes have difficulty figuring out when consent to sex is really valid. She said, “For example, suppose you have a couple and the woman believes that the man she’s seeing is her husband…. she consents to a sexual relationship. Is that really consent if she doesn’t understand who he is and that she’s not married to him?”

She added, “…nursing homes are required to take care of the psychosocial needs of their residents. Whether psychosocial needs would include sexual relationships is a question.”

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