TIME Aging

Why Nursing Homes Need to Have Sex Policies

The question of consent is complicated by Alzheimer's and dementia

No one wants to talk about sex in nursing homes.

The need for sex doesn’t disappear as we age, yet many facilities for the elderly have no policy on sex at all and only acknowledge that it happens when there’s a problem, like concern that an Alzheimer’s or dementia patient is being abused. Whether it’s out of ageism or just discomfort with the idea of senior sexuality, nursing homes are not eager to raise the issue, leaving a massive gray area where the line of consent is blurry.

“We’ll ask them about their religion, the music they like, what kind of food they want to eat. We don’t dream of asking them about their preferences around sexuality and intimacy,” said Dr. Cheryl Phillips, a senior advocate at LeadingAge, an association of nonprofit senior services.

The risks of ignoring residents’ sex lives are real. The issue most recently came to light in Iowa, when Henry Rayhons, 78, a longtime state lawmaker, was charged with sexually abusing his elderly wife, an Alzheimer’s patient, while she was living in a nursing home. Rayhons was acquitted this week, after testifying that he and his wife had shared a loving, consensual relationship. The case, which involved family tension between Rayhons and his step-daughters, was complicated by questions of whether someone with dementia can give consent, and whether Alzheimer’s patients have the right to have sex or the right to be protected from it.

Mr. Rayhons could not be reached for comment, and the administrator for the nursing home where his wife resided in Iowa, Concord Care Center, declined to comment.

When Phillips was a practicing geriatric physician, she dealt with sex often. In one particularly thorny case, two residents of a nursing home who both had dementia had begun kissing and holding hands, even though they were both still married to spouses who lived elsewhere. The nursing home lovebirds, though, each believed the other was their spouse. After consulting with the families, the nursing home decided to allow the budding relationship to go forward, since it was bringing the two so much happiness.

“The lesson we took out of that is that it is good to talk with families and be open about values and preferences,” Phillips said. However, she added, “There’s a flip side. Elders deserve privacy. If I’m in a nursing home and I’m attracted to a man, do you have to get my son’s permission for me to be intimate? Where are the boundaries with intimacy? That is where we as a country are really struggling. We don’t have good answers.”

When it comes to managing the sex lives of nursing home residents, the problems are not going away. By 2030, nearly 20% of the U.S. population will be 65 or older, according to Pew Research Center. And according to the World Health Organization, there are 47.5 million people with dementia, a number that will nearly double by 2030.

Today’s aging Americans also grew up with fewer sexual limits than earlier generations and may be unwilling to live in nursing homes that don’t accommodate their sex lives, experts say. “Let’s be real. Baby boomers brought the sexual revolution to America in the ’60s—what are they going to bring to nursing homes?” Roberta Flowers, co-director of the elder law center at Stetson University College of Law, told TIME.

But elder advocates, physicians and nursing home experts say that there is no national standard of best practices for how nursing homes should accommodate residents who are sexually active. The policies that do exist are archaic, regressive and even ageist, and do not acknowledge that nursing home residents could happily have consensual sex with each other.

One exception is the Hebrew Home at Riverdale in the Bronx, which is cited by many as the leader in progressive policies on sex. The Hebrew Home has a Sexual Expression Policy, which “recognizes and supports the older adult’s right to engage in sexual activity.”

Daniel Reingold, the CEO of Riverspring Health, which operates the Hebrew Home, said they developed the policy in 1995 after realizing that residents were having sex and the home had no plan for dealing with it. The problem became clear to him one day when he was walking down the home’s hallway and a nurse came up to him and asked him what she should do about two residents having sex in one of the rooms. “Tiptoe out and close the door!” he replied.

Reingold says many of his colleagues in the nursing home community are reluctant to adopt policies because of liability, and also just plain nervousness around sex. The issue is also complicated by adult children who are uncomfortable with their parents’ sexual lives, particularly if there is adultery. “It reflects ageism at its worst. People don’t want to acknowledge that old people have sex,” he said. “Intimacy and sexuality is a civil right no different than the right to vote.”

The question of whether the elderly should be having sex is most troubling when it comes to dementia. But experts and elderly advocates say people with dementia are capable of consenting to sex, that they are able to express that consent, and that sex and touch can be good for them, which makes it difficult to know when it is appropriate to set limits. Hebrew Home’s policy is explicit that patients with dementia and Alzheimer’s can give consent to sex, either verbally or non-verbally.

“A 12-year-old can’t consent to sex with an adult today or tomorrow. You can’t have the same black-or-white rule for someone suffering from dementia,” said Flowers, the expert on elderly law. “Someone with dementia is not incapacitated all the time for all things. If they are not incapacitated at the moment of the sex act, they have a right to have sex.”

She added, “It’s a difficult issue and it’s not going away.”

Nursing homes must establish policies, and must be comfortable talking about sex with residents and their families, advocates said. “People want to have sex. That doesn’t change merely because you have gray hair,” Flowers said. “We have got to be willing to talk about it.”

TIME animals

Popular Pesticide Hurts Wild Bees, Study Finds

European honeybee
Marijan Murat—picture-alliance/dpa/AP European honeybees are busy at work on a honeycomb in their behive on the rooftop of the town hall in Stuttgart, Germany, 13 April 2015.

New research could lead to pesticide bans in the U.S. and Europe

A common pesticide is hurting wild bees, while sparing their honeybee cousins, a new study found.

The data, published in Nature on Wednesday, could have an effect on whether regulators in the U.S. and Europe will continue to allow the use of the pesticides.

The study showed that neonicotinoids, a commonly used class of insecticides, “reduced wild bee density, solitary bee nesting, and bumblebee colony growth and reproduction,” indicating that the insecticides could be contributing to the decline in wild bee populations globally, a key issue in food security. The study found that the insecticide was not as harmful for human-raised honeybees, suggesting that scientists cannot extrapolate a chemical’s effects on honeybees to their wild cousins.

Read More: A World Without Bees

Adding to the concern, a second study published in Nature showed that two different kinds of bees seem to prefer crops coated in the pesticides, undermining the claim from pesticide defenders that bees can choose pesticide-free crops.

The European Union has instituted a temporary ban of the pesticides that is up for review in December. The U.S. does not have a ban, but the Environmental Protection Agency announced earlier in April that it was unlikely to approve new outdoor use of neonicotinoid pesticides, pending new data. These new studies may have an effect on that decision.

 

TIME Books

Jon Krakauer Defends New Book on College Rape

The 'Into Thin Air' author's new book, 'Missoula,' has stirred the college town

In 2011, Gwen Florio, a dogged reporter for Missoula, Montana’s local paper, reported on a number of rapes involving University of Montana football players that had gone unpunished by school or local authorities. Her stories eventually led to a Justice Department investigation into the alleged mishandling of 80 reported rapes in Missoula over a period of three years; the investigation resulted in settlements between the federal government, local law enforcement and university officials. But the circumstances led Missoula — a laid-back, academic town of only 70,000 — to be referred to in the ensuing national press America’s “rape capital.”

Now synonymous with its recent legacy, “Missoula” has become the title for a new book by best-selling author Jon Krakauer. Krakauer said in an interview that his working title was What Happened in Missoula, but he ended up preferring the one-word title his publisher and editor gave the book because it was “non-sensational” and “almost academic.” What he means by “academic” is that the book, out this week, serves as a case study of the widespread problem of campus rape, and how they are handled.

Rankled by the bad publicity, many in the Missoula community have criticized the title of the book, subtitled Rape and the Justice System in a College Town, for unfairly singling out Missoula in what is a national issue. But Missoula works as a case study in large part because so many of the high-profile rapes there were reported to the police and the university, and litigated in court. Indeed, Krakauer said, he chose to write about Missoula in part because of the availability of official documents he could rely upon for his reporting. Time focused on Missoula to report our cover story (which I wrote) about campus rape for many of the same reasons. When there is a paper trail as clearcut as the one in Montana, it makes reporting about rape less susceptible to the kinds of issues that plagued the UVA story recently retracted by Rolling Stone. Here, Krakauer has uncovered many new documents — but documents nonetheless — himself for the book. Missoula even stands a corrective to the controversy surrounding the Rolling Stone story, which many critics said set back the clock decades on rape activism and advocacy.

Krakauer is clearly supportive of victims; his inspiration to write the book came out of a personal friendship he shared with a woman (not from Missoula) who was raped as a teenager. His vantage point offers a sharp argument against the inherent flaws in America’s adversarial criminal justice system in which, Krakauer writes, “Due process trumps honesty and ordinary justice.” For anyone distressed by the high rate of sexual assault afflicting young women, and who wants to understand some of the ways in which the justice system fails them — and shouldn’t that be all of us? — Krakauer’s book is worth reading.

“I am sorry everyone is bent out of shape. I understand why, but I don’t apologize for the title,” Krakauer said. He said that he was disturbed by the town’s focus on negative publicity instead of the rapes that happened there. “They are outraged that the city was besmirched by the book title, not by what is revealed in the book…. That doesn’t make me think well of Missoula. They are focused on the wrong thing here. They say it was not worse than any other town, but that’s not something to be proud of.”

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME LGBT

Same-Sex Military Spouses Speak of Unique Obstacles

Frequent moves and fragile parental rights highlighted ahead of Supreme Court arguments

Ashley Broadway-Mack was living in North Carolina in in 2013 when her wife Heather Mack, a Lieutenant Colonel in the U.S. Army, had their child Carly. But same-sex marriage wasn’t legal in North Carolina at the time, meaning Carly, now 2, couldn’t have Broadway-Mack listed as a parent on her birth certificate. Brodway-Mack eventually managed to become a legal parent to Carly after she traveled to South Carolina (where so-called “second-parent” adoptions are legal) and spent thousands of dollars to legally adopt her. Same-sex marriage became legal in North Carolina last October.

“We just want to be recognized lawfully like every other military couple and couple in the U.S,” Broadway-Mack told TIME in an interview this week. “We want our marriage to be recognized and our kids to be protected. Men and women in uniform are fighting for our rights and can’t be given the same rights they fight for.”

Stories like Broadway-Mack’s are behind a legal brief that former military officials filed to the Supreme Court ahead of hotly anticipated oral arguments next week about whether states can ban same-sex marriage—arguments many think will end in the high court ruling that marriage is a constitutionally protected right. The brief, reported by the New York Times, argues that the inconsistent state laws on same-sex marriage hurt same-sex married families, and ultimately military readiness. Gay couples in the military move frequently, and have little—if any—choice in deciding where they live. If they move from a state that recognizes their union to one that doesn’t, they are at risk of losing protections and benefits, such as spousal veteran’s benefits distributed by the Department of Veterans Affairs.

”Those willing to risk their lives for the security of their country should never be forced to risk losing the protections of marriage and the attendant rights of parenthood,” the brief argues, ”simply because their service obligations require them to move to states that refuse to recognize their marriages.”

Broadway-Mack, whose wife is stationed at Fort Bragg in North Carolina and who made headlines in 2013 when she was denied entrance to Association of Bragg Officers’ Spouses, said that for gay couples who have children, the issue becomes that much more urgent.

“Before when it was just Heather and me, we were just used to it,” she said. “Now that there are kids involved, it is extremely stressful.”

Roya and Jennifer Cintron, a couple in their early 30s who both serve in the Army, met at Fort Bragg in 2009 when they were en route to their deployments in Afghanistan. They married in New York in 2013. But in February, the couple moved from New Jersey, where their marriage was legally recognized, to Fort Sam Houston in San Antonio, Texas, where same-sex marriage is not legal.

Roya gave birth to the couple’s twin girls, who are now almost a year old, in New Jersey. And while both parents’ names are on the girls’ birth certificates, Jennifer, who did not give birth to the girls, now has to apply to legally adopt her daughters. Roya Cintron said she was optimistic about the sea change in policies and perceptions around same-sex marriage that have been sweeping the country (the “don’t ask, don’t tell” law banning openly gay people from serving in the military was repealed in 2010). But she said the patchwork of rules still makes for anxious parents, especially in military families where at least one parent could be deployed away at any moment.

“You just never know where the military going to send you,” she said, “even overseas.”

TIME Television

Anne of Green Gables Star Jonathan Crombie Dead at 48

Ahmanson Theatre Opening Performance Of "The Drowsy Chaperone"
Ryan Miller—Getty Images Jonathan Crombie during the party for the opening night performance of "The Drowsy Chaperone" held at the CTG Ahmanson Theatre on July 9, 2008 in Los Angeles.

The actor was best known for his role as Gilbert Blythe

Jonathan Crombie, the actor who played Gilbert Blythe in the CBC miniseries Anne of Green Gables, has died. He was 48.

His sister Carrie Crombie told CBC News that her brother died of brain hemorrhage in New York City on April 15.

Crombie’s best-known role was as Gilbert Blythe, the love interest and boy next door in the Anne of Green Gables TV movies. Cast in the first film at the age of 17, Crombie beat out many actors including Jason Priestley. Crombie was also the son of David Crombie, the mayor of Toronto from 1972 to 1978.

“He was funny, he was sweet, he loved acting, he loved comedy and singing and dancing. As a little kid, he just loved Broadway shows and all of that kind of stuff and would sing and dance in the living room,” his sister said.

TIME england

Titanic Deckchair Sells for 100,000 Pounds at Auction

MAHOGANY DECK CHAIR RECOVERED FROM TITANIC IS SEEN IN THE MARITIME MUSEUM OF THE ATLANTIC IN HALIFAX
Paul Darrow—Reuters /Landov A mahogany deck chair from the Titanic recovered by the crew aboard the CS Minia is seen in the Maritime Museum of the Atlantic in Halifax, Canada, January 27, 2012.

A crew dispatched to gather bodies from the water found the chair in 1912

Correction appended, April 21

A deckchair that was pulled from the wreckage of the Titanic more than a century ago has found a new home.

The chair was sold at an auction in England on Saturday, fetching just over 100,000 pounds including taxes and fees, or nearly $150,000, a representative of the Wiltshire auction house told TIME.

The chair sat on the first-class deck of the luxury ship that sank after hitting an iceberg in 1912, killing 1,500 people.

It was discovered floating on the surface of the ocean by a crew dispatched to recover bodies from the wreckage in 1912, the Guardian reports. The chair originally belonged to a member of that crew, and then to an English Titanic collector who owned it for the last 15 years and used it as a display item in his home.

It was sold by auctioneer Henry Aldridge and Son to an unnamed collector in the U.K.

Correction: The original version of the photo caption accompanying this story misstated the location of the Maritime Museum of the Atlantic. It is in Halifax, Canada.

TIME health

Meet the Utah Teen Who Is Allergic to Water

Only 50 cases of the condition have been documented worldwide

Ever since she was a little girl, Utah teen Alexandra Allen has broken out in hives every time her skin was exposed to water.

In 2013, her family discovered that her condition was most likely aquagenic urticarial, an allergy to water when it comes in contact with the skin. There are only 50 cases documented in medical journals worldwide.

To avoid water exposure, Allen takes five-minute cold showers twice a week, cut her hair short and became a vegetarian so her body would produce less oil.

Read more at People.com.

TIME animals

These Endangered Penguins Are Getting ‘Honeymoon Suites’

Biologists hope privacy will encourage endangered African penguins to breed

Things are about to get a little racy between the animals at the New England Aquarium.

Aquarium experts are building “honeymoon suites” for eight pairs of endangered African penguins, as a way of encouraging them to breed more chicks, the Associated Press reports. The aquarium hopes to grow the population of the birds, which are expected to be extinct in the wild by 2025.

The honeymoon suites will be plastic igloo-like homes and private nooks built off of the main exhibit to protect the penguins’ modesty from the prying eyes of the aquarium’s visitors.

 

TIME Companies

Alfred Taubman, Inventor of Indoor Shopping Malls, Dies at 91

Al Taubman
Carlos Osorio—AP This Oct. 10, 2008 photo shows shopping mall mogul A. Alfred Taubman in Waterford Township, Mich.

He capitalized on the trend of Americans moving to the suburbs in the 1950s

Alfred Taubman, a real estate developer who invented the concept of indoor suburban shopping malls, has died at 91.

His son, Robert Taubman, the chairman of his father’s company, shared the news on Friday.

“He was so proud of what this wonderful company he founded 65 years ago has accomplished,” Robert Taubman said in a message to the company’s employees. “Tonight, after dinner in his home, a heart attack took him from us, ending what was a full, extraordinary life that touched so many people in so many wonderful ways around the world.”

Alfred Taubman was born to German Jewish immigrants in Michigan in 1924, CNN reports. When he noticed in the 1950s that Americans were moving to the suburbs, he thought they would need centralized places to shop. It was a brilliant innovation. In 2015, Forbes put his net worth at $3.1 billion.

But Taubman’s business life was not always rosy. He bought Sotheby’s auction house in 1983 and was sent to jail for nine months in 2002 after he was convicted of conspiring with Christie’s to fix auction house commission rates. He maintained his innocence.

TIME Environment

Millions of Jellyfish Invade Pacific Northwest Beaches

Jellyfish are washing up on shore in Oregon and Washington

Beach-goers beware.

Millions of jellyfish are washing up on the shores of beaches in Washington and Oregon, CNN reports.

It is not unusual for the bluish-purple species called Velella velalla to turn up in the spring, but a sail fin on their body usually keeps them away from the shore. This spring, though, their sails were no match for the wind.

The species, also known as “purple sailor,” has stinging cells that are not seriously harmful to humans, but the Oregon State website warns it’s best to avoid rubbing your eyes after touching them or walking barefoot through them on the beach.

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