Intimacy in Assisted Living

The assisted living industry provides residential, medical, nutritional, functional, and social services for approximately 1 million older adults in the United States. This category includes assisted living homes as well as residential care facilities for the elderly located within assisted living facilities or independent living retirement communities such as the one at, complexes that provide health related services to the elderly on an ancillary basis.

Despite their holistic approach to person-centered care and their emphasis on a consumer-empowered, social environment, assisted living providers pay scant attention to clients’ sexual needs. Lack of engagement by providers and the lack of culturally competent training often results in unawareness of the importance of sexual health as a part of overall quality of life for all adults of all ages regardless of health status and related stigmas and concerns for those individuals diagnosed with all forms of dementia within long-term care programs and other elders who are sexually marginalized due to disability status or other marginalizations or privacy concerns associated with the aging population.

Because assisted living continues to be a strong option for residential long-term care for growing numbers of older adults, it is critical to determine residents’ expectations and experiences of sex and intimacy in this environment in order to understand both current and potential gaps in services and to support healthy aging initiatives in these settings and those related to housing and living options for individuals with all types of disabilities worldwide.

It’s important to contribute to an understanding of how sexuality and intimacy are experienced within the social models of care provided in assisted living communities and how these factors may impact overall well-being and quality of life of people who live within this setting – especially as it relates to those already struggling with the uncertainties associated with memory and cognitive issues. The importance of maintaining sexuality over the life course, as well as continued sexual desire and participation in sexual expression by older adults needs to be acknowledged as part and parcel of fulfilling individual meaning and purpose in life that is meaningful to clients according to their specific needs and abilities and preferences.

Although sex in assisted living can be enjoyable, a physical release, and expected behavior, victimization also occurs. Many individuals opt for assisted-living settings as a result of injuries from falls during sexual encounters. In addition anecdotal reports indicate that among individuals in cognitive decline who have engaged in sexual activity while residing in these facilities and then are no longer capable of consenting to it generally do not report instances of sexual assault because their bodies are not believed to be able to prevent unwanted advances; medical staff members are also typically not knowledgeable about issues of abuse involving patients with cognitive impairment.

About Karen Rayne

Dr. Karen Rayne has been supporting parents and families since 2007 when she received her PhD in Educational Psychology. A specialist in child wellbeing, Dr. Rayne has spent much of her career supporting parents, teachers, and other adults who care for children and teenagers.