Social and sexual issues in aged care

Living in aged care does not spell an end to sexuality. Here’s how we help residents, nursing homes and families work together to address this often taboo subject.

One of the most difficult things about moving into aged care is that people often think old age means depleted sexual desire – including sexual abstinence.

But, actually, that assumption is wrong. The sexual part of a person’s brain still functions well into the later years of life. Older people have the same desires as younger people and they can still crave human touch, intimacy, romance and the need to feel attractive.

For some family members of residents in aged care facilities, and the staff working there, it can be challenging and confronting when these sexual desires play out.

In fact, research shows: “Usually, the residents do not get appropriate response to their need, because the aged-care staff lack adequate knowledge on the subject.”

What’s more, sexual issues in aged care can be complicated with cognitive impairment such as dementia. And, according to Australian Institute of Health and Welfare research, 52 per cent of people in permanent residential aged care have a diagnosis of dementia.


If someone has frontotemporal dementia (FTD) for example, which is when progressive damage has occurred to the frontal and/or temporal lobes of the brain, their behaviour, habits, personality and emotional responses can change.

Exhibiting embarrassing behaviour, acting on impulse and a loss of empathy – coupled with ongoing sexual desires – can mean the resident may display their sexuality in public physically or verbally. This can sometimes be directed at other residents, staff or family members.

Without a set framework from which to respond, staff will tend to rely on their own set of values or morals when it comes to managing the situation.


The key is to avoid prohibiting older people from their sexuality because this can lead to social isolation, loneliness and depression.

We must also keep the Australian Government Department of Health, Charter of Residents’ Rights and Responsibilities in mind, which outlines residents:

  • To be treated and accepted as an individual, and to have his or her individual preferences taken into account and treated with respect; and
  • To select and maintain social and personal relationships with any other person without fear, criticism or restriction.

To help, Melbourne Geriatricians Group work together with residents, families and nursing homes to comprehensively assess the individual’s circumstances.

We then write a policy that addresses all aspects of the resident’s sexual health. It outlines appropriate interventions that ensure the resident’s needs and behaviours are managed with dignity, privacy and respect.

The policy is printed and easily accessible for carers so that staff on every shift take a consistent approach.

As a result, once families and carers understand the medical reasons behind why an older person might feel and demonstrate their sexual desires, plus how to safely intervene, they are more likely to help the resident rather than feel ashamed, embarrassed or at a loss as to how to broach social and sexual issues in aged care.

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