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Sexuality and dementia in residential care--whose responsibility?

This paper addresses the theme of responsibility when resident sexual expression becomes a component of care work. A short review of the medical and social models of care is followed by an exploration of findings from case study material from a doctoral research programme undertaken in one social work residential home in Scotland. While it is not possible to generalize from this small empirical study, the findings offer some interesting insights. The 'halo' effect of dementia where people are often viewed as not responsible for their actions is questioned. The ambiguous nature of the condition points to dementia being a contested area. Resident responsibility appears dependent on how mentally capable each of the staff perceive the resident to be and this may vary. Responsibility appears also a concern for women staff. It was seen as staffs' own responsibility not to place themselves at risk from the sexual advances of male residents at the social evenings of the home or at other times. If staff were accosted some were made to feel in some way responsible. Training, a proactive approach by managers to resident sexual expression, and long-term emotional support for staff appeared lacking.