Iowa Case Sheds Spotlight On Whether People With Alzheimer's Can Consent To Sex

When is someone who is suffering from dementia no longer able to consent to sex? That is the big question that is drawing the attention of Alzheimer's disease experts and elder law scholars to an Iowa courtroom this week.

Henry Rayhons, a 78-year-old former Republican state legislator, was accused last summer of sexually abusing his wife after he had sex with her in the nursing home where she lived as a dementia patient. His wife, Donna Lou Rayhons, died on Aug. 8, 2014, a week before her husband was charged with one count of third-degree sexual abuse. The trial begins Wednesday.

The Washington Post and other outlets reported that the marriage was the second for both Henry and Donna Rayhon. According to Bloomberg, Henry Rayhon disagreed with his wife's adult daughters about how to best care for their mother as her health deteriorated.

Katherine C. Pearson, an elder law professor at Penn State University, told The Huffington Post that the case is significant because "it represents a prosecutor willing to pursue criminal charges against a husband for alleged sexual relations with his wife on the grounds that dementia makes it impossible for her to consent to those relations."

"The prosecutor is focusing on Alzheimer’s as a 'mental defect' (the statutory term in Iowa) as preventing her from having any ability to consent," Pearson said. In that sense, the prosecution is seeing Alzheimer's as "a mental defect with an on/off switch, and treating it as a switch that can never go back to 'on' once it is in the off status."

But, she noted, "Capacity ... does fluctuate with Alzheimer’s, as I would expect medical evidence to explain if the defendant calls witnesses."

Elizabeth Edgerly, a clinical psychologist who serves as chief program officer for the nonprofit Alzheimer’s Association, told the Associated Press that it can be hard to determine capacity in cases of dementia. “Is the person capable of saying no if they don’t want to do something? That’s one of the biggest pieces,” she said. Edgerly noted that physical closeness with loved ones is often helpful to people with Alzheimer's.

Pearson raised another issue: "What I think is troublesome about this case for the general public is the implication that a spouse could lose all rights to 'enjoy' life at its most fundamental level because of a diagnosis of Alzheimer’s."

The state attorney general's office did not return a request for comment.

Pearson said that as an academic observer from afar, it seems clear that Donna Rayhon's daughters "are entirely well-meaning and wanted their mother protected.”

"Perhaps they were even seeing this [pursuing criminal charges] as a way of protecting their mother from herself," she said. "The fact that this is a second marriage is part of the dynamic of the case."

Rayhons’ prominence in the area -- he withdrew from seeking a 10th term representing North Iowa voters when he was charged -- prompted the Iowa attorney general’s office to try to move the trial out of Hancock County. The request was denied.



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