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Dementia And Sex: What Was Really On Trial With Henry Rayhons

An Iowa jury on Wednesday found 78-year-old Henry Rayhons not guilty of charges that he sexually abused his wife by having sex with her in a nursing home after the staff told him her Alzheimer's rendered her cognitively unable to give consent.
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What took place in Iowa, won't stay in Iowa.

Rayhons, a former Republican state legislator, faced a felony charge that could have imprisoned him for up to 10 years.

But the case against Rayhons was less about him and more about what rights dementia patients have when it comes to intimacy. The thing about Alzheimer's is that its sufferers often have fleeting moments of lucidity, and as aging expert Daniel Reingold told The Huffington Post, "This case has opened the door to a conversation people really don't want to have about sexuality, old age and dementia."

Reingold is CEO of Riverspring Health, the company that runs the Hebrew Home of Riverspring in New York -- voted by US News as one of the nation's top nursing homes in 2015 and the birthplace 20 years ago of the nation's first nursing home "sexual expression policy." The policy spells out the home's position that active sexual relations and intimacy are good for its residents and thus encouraged. The policy was recently updated to add specificity to the care of Alzheimer's patients, said Reingold.

The policy guides staff, patients and their families, when patients seek intimacy -- yes, have sex. Staff are taught to not be judgmental or to bring religious, cultural or personal beliefs to work with them. They are instructed on how to help residents consummate intimacy in a safe and private setting. Rooms are arranged to accommodate sexually active residents and, sometimes, he said, staff do things like put a "do not disturb" sign on the door.

Did that last part make you giggle? Reingold says that's the problem. While boomers may have liberated sexual barriers, they are damn uncomfortable with the idea that their parents may still want to have sex. And it's why the Hebrew Home has its policy -- to protect those residents who don't want to be intimate and to ensure that those who do are able to.

By the way, the Hebrew Home policy is not restricted to legally married couples having sex with each other. In fact, married residents who no longer recognize their spouses may be intimate with other residents, once the families are informed. That gets a little dicey sometimes, but Reingold defends his patients' right to intimacy.

As Alzheimer's erases memory, even long-married patients may stop recognizing their spouses. And sometimes, in a practice rarely discussed publicly, patients fall in love with someone entirely new, said Reingold. It was headline news when the 77-year-old husband of retired Supreme Court Justice Sandra Day O'Connor, John Jay O'Connor III, "found companionship with a woman in the nursing home in which he lives" as the New York Times gently put it, noting, "The two patients reportedly spend time together and hold hands, even in the presence of Justice O'Connor."

"Aging involves episodes of loss. We lose friends, loved ones, our independence. We lose the ability to use our bodies in the ways we always took for granted. Why would we want to lose our ability to respond to touch?" said Reingold. "As far as we're concerned, we will encourage our residents to have sex as long as it is consensual."

The Rayhons case really hit a nerve, Reingold said, because Donna and Henry Rayhons were married. "A married couple has absolutely every right to be intimate. For the court to try and legislate intimacy between a married couple is a very dark road to go down." And while not insensitive to the idea that dementia was involved, he said, there are different definitions of capacity. "It is one thing to have the capacity to make a complex medical decision for yourself and quite another to have the capacity to enjoy the touch of your husband," he said.

So what happens after the Iowa case? Things will only get more complicated, said Reingold. About 10,000 people a day turn 65 and the ranks of the elderly are growing. Social filters frequently disintegrate with Alzheimer's and behaviors change. He offered the example of a woman who was a dutiful wife and mother in the 1950s and 1960s, now has dementia and is engaged in a same-sex relationship. Viagra opens a Pandora's Box. The issues, including our own discomfort with the idea of our aged parents having sex, are important and real.

"The Rayhons case? I'd call it unfortunate," said Reingold. "But truthfully, I'm glad it happened because at least now we are talking about it." Amen to that.

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