Midway through the Q&A section of a webinar on older people’s sexual rights, a woman named Beverley asks whether aged care providers can confiscate residents’ sex toys.
The question is deftly handled by one of the experts, Dr Catherine Barrett from Celebrate Ageing, who gently asks, “I wonder why you would want to remove those items? Are they infringing on the rights of somebody else? So if a resident wants to use sex toys, if they want to pleasure themselves in the privacy of their own room, they have the right to do so.”
Another panellist, Gwenda Darling, 71, a Pallawa woman who is a member of the Aged Care Council of Elders, is even stronger in her response. She says she would be asking different questions: “Do aged care workers have a responsibility to ensure there are enough batteries, or do we ensure they have a mains charged vibrator?”
At another point she suggests that instead of constantly running bingo events, aged care facilities could run a sex toy party – bringing the products into the facilities for residents to purchase.
More than 1,000 people signed up for the webinar, run by the Older Persons Advocacy Network in late June, including aged care workers, older people and their families. Craig Gear, the CEO of Opan, says that questions like Beverley’s get to the heart of the issue that the event was run to address.
“What right do you have to take [the vibrator] away? You don’t. That’s the personal property of that person, and you wouldn’t take their dentures away from them. So why would you consider that, if someone’s [using it] in their privacy of their room?”
A LaTrobe University survey of more than 3,000 Australian residential aged care facilities last year found only about half had written policies on sexuality, only one in six had policies on sexual health and only one-third had policies on sexual behaviour.
Gear says it’s “fundamentally about ageism”. “The ageism of not seeing older people as able to be sexual beings.”
‘We’re being denied a basic human right’
Barrett is one of the pioneers of research and advocacy on this topic in the country.
Through her work, she has been told about aged care facilities where porn magazines were confiscated from residents; of staff horrified to discover an older person masturbating or watching porn on their iPad, with headphones on, in their privacy of their own room; of people coming in to aged care facilities and striking up romantic or sexual relationships that staff disapprove of, or families complaining about and then staff deliberately separating the couple; or of people entering into residential care and then coming out as gay or transgender, and of staff being unsure how to handle the situation, especially if the family don’t approve.
“I think there is this ageist belief in our community that older people are not sexual,” she says. “And then you’ve got workers in aged care that have not had a lot of training, and they find themselves with people who are their grandparents’ age … and then when they see older people expressing sexual intimacy together, it can be really shocking and embarrassing. And I think that’s where it gets shut down from.”
Part of the reason to be talking about sexual rights, Barrett says, is the atrocious and stubbornly high rate of sexual assault against older people. There are roughly 50 complaints a week of sexual assaults in residential aged care in Australia, which Barrett calls a “source of shame and disgrace”.
“We are never going to be able to prevent sexual assault until we put down, in black and white, the sexual rights and responsibilities, but particularly the sexual rights of older people. We’ve got to create this baseline understanding that older people are sexual beings.”
The issue of consent is a huge one, particularly as it relates to people with dementia. More than half of people living in residential aged care in Australia have dementia.
“It’s really important to remember,” says Darling, who has early onset dementia, “When you see one person living with dementia, you see one person. There are so many types and variants of dementia.”
Darling says the issue of consent has to be seen not just as the right to say no, but as the right to say yes to sex and not have others assume that this consent is invalid.
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“I’m pansexual, so they can be male, female, trans, non-binary,” she says. “If I say no, it is no. No is always no, regardless. But I also think yes is also yes, if I’m not being coerced.”
“I just want to be able to have sex when I want it. I just want to be able to get my vibrator out when I want to … We’ve got enough shame and stigma by having a dementia diagnosis anyway,” Darling says. “But now we’re being denied a basic human right that’s one of the human needs, like sleep, like food, like water, it is sex. And if I need sex, I would hope that somebody would ensure that I was able [to].”
‘Institutionalisation’ driving both abuse and suppression
Barrett says that for those working with people with dementia, it is about checking in to make sure relationships and activities are consensual, remembering that a person with dementia might be able to consent one day and not have the capacity to do so the following day.
She adds that there can be real heartbreak involved for family members, if, for instance, someone with dementia moves into a residential care home, forgets about their long-term partner, and strikes up a new relationship with someone in the facility. The new relationship can be consensual and positive for the person, even as it is emotionally devastating for their loved ones.
“It becomes about levels of dementia, but it becomes really very nuanced. So it’s about whether or not that person understands what they’re doing and gives consent freely,” Barrett says.
Theresa Flavin, 57, has early onset dementia, which was diagnosed about a decade ago. She sees the sexual abuse of older people and the repression of positive consensual sexual activity among older people as two sides of the same coin.
“What is the driver of all of the abuse figures you see, and what is the driver of all the suppression of sexual expression that you see? It is the institutionalisation [of people with dementia] based on disability status … [and] the paternalistic system where people continuously want to make the rules for us, but not with us.”
Flavin lives independently but was visiting a high care dementia ward when three male residents pulled out their penises and began masturbating in a communal TV room. They began approaching the women in the room and asking them to touch them.
Flavin says she asked the care worker to intervene, but “her response to me was, ‘they have a human right to do [this] and it’s very complicated, and you wouldn’t understand’”.
“It was unsafe. It was unsafe for the women, the care staff. She was one small … woman who absolutely could not have got up safely and escorted one of these six-foot men to another room by herself. There is no training to undertake. It’s not accessible.”
Gear says that this need for training is exactly why Opan has stepped in and started running workshops and providing material to aged care workers and their families.
“People suck up this training. They love it,” he said. But it likely will not be a “one-hour webinar that just gives you all the skills at the end of it. This is a rolling, ongoing program where we need to keep educating people about this, this area, to give them those skills.”