Elders and Intimacy: When Is It a Concern that Requires Attention?

By Elizabeth Landsverk, M.D.

We focus a lot on care for older individuals; Are they eating? Are they moving their bowels? Do they walk? Are they agitated? But what about intimacy? What about romance? When is there risk for an elderly person and when does a family member or caregiver need to butt in or butt out of an elder’s intimate life? These are questions that are real and about which families, caregivers, and medical professionals needs to be sensitive.

Contact and physical affection are important, and this is where it can get delicate. Romance and sex are on the spectrum of affection and in our culture as it relates to elders, it has a “Harold and Maude” feel to it. They are too old for that! But this is not true and often it is lovely and life sustaining for competent elders to be in a relationship. The key is making sure that everyone is safe and in agreement with what is going on.

Tips for when to be concerned and when to butt out

It is tricky knowing when to be concerned about intimacy between elders, but It is reasonable and responsible to address the following questions:

• Can they get hurt?
• Are they consenting?
• Are they happy in the relationship or is it causing them stress and agitation?
• Do they have the capacity to understand the risks of undue influence?
• Is there a risk for associated financial abuse?

If you are discussing an intimate relationship between competent elders, it’s none of your business unless there is evidence that the arrangement is detrimental for the elder, from isolation, undue influence, abuse or neglect.

if your father wants to be with a young woman (e.g. Anna Nichole Smith) and he fully understands the risks and benefits, that is perfectly OK and nobody’s business but his own. However, if there is doubt about the elder’s ability to understand the risks, or if the person courting the elder is using undue influence, then an evaluation with a neuropsychologist and an elder law attorney is imperative. An elder law attorney can help safeguard and individual’s assets for their use. If this ruins the relationship and the love interest flees, then the risks were real and the elder was appropriately protected.

Elizabeth Landsverk, MD, isfounder of ElderConsult Geriatric Medicine, a house-calls practice in the San Francisco Bay Area that addresses the challenging medical and behavioral issues often facing older patients and their families. Dr. Landsverk is board-certified in internal medicine, geriatric medicine and palliative care and is an adjunct clinical professor at Stanford University Medical School. http://www.elderconsult.com