Sex bans in nursing homes

More than 30 years ago, in Arkansas, a sociologist proposed to a group of nursing home operators that they set aside "privacy rooms" for their residents to do whatever it is that consenting adults do in private. Professor Eddie Hargrove maintained that hand-holding, kissing and petting "probably would go further than a little medication at 10 o'clock at night," according to the New York Times.

The nursing home operators all rejected this idea then, and it apparently has not gained much ground since.

Flash forward a generation, and an advocate for medical marijuana asked me recently if -- in my role as a psychologist in long-term care facilities -- I had ever seen it used in nursing homes. I could only lamely reply, "That's about as likely as sex."

I'm no expert on sex, and I'm not a lawyer, but where is the law that says you check your rights and liberties at the nursing home door?

There is none that I know of. In fact, the law says you retain the right to a sex life wherever you reside.

The federal government -- which pays for most long-term care through Medicare and Medicaid -- enacted the Nursing Home Reform Act of 1987, mandating that continued federal funding for a nursing home required the institution to maintain an environment in which each resident can "attain and maintain his or her highest practicable physical, mental and psychosocial well-being."

In addition to specifying that certified nursing homes provide basic services such as physical therapy and recreation, the law also contains a Residents' Bill of Rights that includes the right to privacy and the accommodation of personal needs.

At the local level, many states have followed up with a further enumeration of individual rights in long-term care. In California, for example, the Welfare and Institutions Code specifies that residents have the right "to live in an environment that enhances personal dignity, maintains independence and encourages self-determination," and "to participate in activities that meet individual physical, intellectual, social and spiritual needs."

Then why is it so hard to remain sexually active in a nursing home?

First, it's hard to find any privacy in nursing homes. Doors are always open; a closed one is viewed with the suspicious eyes of a teenager's mother wondering what's going on in there. I recently had a resident referred to me for masturbating in front of an aide who had walked into the room. Why did she walk in without knocking? Well, you can't knock on an always open door. And in your room -- typically shared with a total stranger after a lifetime of independence -- you have only a curtain for privacy.