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Handling Inappropriate Sexual Behaviors in Residents: A Comprehensive Guide

Dealing with residents' sexually inappropriate behavior requires a tactful and compassionate approach. In nursing homes, these behaviors can arise from a variety of factors, impacting residents of all ages and genders. It's important to be well-prepared to respond effectively to such situations.

Elderly Kissing

Identifying Early Warning Signs of inappropriate sexual behaviors


Before a situation escalates, it's crucial to recognize subtle hints that may indicate a resident's potential for inappropriate sexual behaviors. Pay attention to residents who frequently discuss sexual activities, engage in excessive self-touching or touch others inappropriately, or share explicit jokes. Although these signs don't necessarily indicate imminent inappropriate behavior, they can serve as valuable indicators. Discuss these observations in care planning meetings and collaborate with your team for additional insights and advice.


Responding with Empathy and Authority


When faced with inappropriate behavior, avoid passing judgment. Understand that many residents who exhibit such behavior lack control over their actions. Your priority is to protect everyone involved. Address the behavior firmly yet respectfully. Use direct and simple language, such as "Please refrain from touching me there," "Mrs. Jones prefers her personal space, kindly leave her room," or "Let's return to your room." It's essential not to make light of the situation or share details with other residents or visitors. Keep discussions restricted to the appropriate staff.


Guiding Behavior Appropriately


Impaired cognitive function can lead to a resident's inability to distinguish appropriate from inappropriate behavior. As a caregiver, offer suitable alternatives. For instance, if a resident is engaging in public masturbation, guide them to their room for privacy. Similarly, if offensive language is being used, try redirecting the resident's focus through engaging activities.


Disincentivizing Inappropriate Behavior


Your manner of speech and attire can impact residents' perceptions. Dress and communicate with sensitivity. Dressing provocatively or using terms like "sweetie," "sugar," "baby," or "handsome" might be misconstrued as flirtation, especially when residents' cognitive faculties are compromised. It's essential to avoid inadvertently reinforcing inappropriate behavior. In group settings, ensure that your responses don't encourage or normalize such conduct.


Collaborative Approach to Addressing Behavior


Ignoring inappropriate behavior can exacerbate the issue. It's essential for both family members and staff to address such behavior during care plan meetings. Open discussions provide the opportunity to formulate effective strategies for management and prevention.


Seeking Professional Guidance


If a resident's inappropriate behavior leaves you feeling uncomfortable or threatened, don't hesitate to reach out to your supervisor. They can offer guidance on handling the situation, possibly reallocating tasks or arranging for a colleague to be present during sensitive interactions.


Respect for Consenting Adults


While it's crucial to address inappropriate behavior, respect residents' privacy when it comes to consensual interactions between competent adults. In private settings, avoid interrupting masturbation or consensual sexual activities.


Considering Underlying Causes


Some behaviors might have non-sexual explanations. For example, a resident rubbing their genital area could be due to an infection or pain. Residents undressing in public areas might do so to alleviate fever-induced discomfort. It's important to assess if other underlying issues are contributing to the behavior.


The Importance of Human Connection


Never underestimate the significance of human touch. Residents might seek physical contact, like holding hands or hugging, as a means of expressing affection and emotional connection.


In conclusion, handling inappropriate sexual behaviors in residents requires a balanced approach that combines understanding, empathy, and professionalism. By recognizing early signs, responding appropriately, and fostering open communication among staff and family members, you can create a safe and respectful environment for residents to thrive in.


Practice Questions:


1. As you assist Resident Clark with his bath, he tells you what an attractive person you are. As you reach across his bed, he taps you on the buttocks. Although Mr. Clark has some physical disabilities, he has normal mental function. What is your best response?


a. Tell him he should be ashamed of himself and to never touch you again

b. Gently slap his hand

c. Stop the bath and leave the room at once

d. Tell him he is not to touch you that way again


2. True or false? Some residents may make sexually oriented remarks or tell crude jokes because they have behaved this way throughout their adult lives.

a. True

b. False


3. You find Mrs. Penn in a male resident’s bed. Both residents have Alzheimer’s disease. When you approach Mrs. Penn and escort her from the room, she tells you, “Why are you taking me away? I have a right to be with my husband.” What is the most likely reason Mrs. Penn is saying this?


a. She is trying to offer an excuse for being in the bed of a man to whom she is not married

b. She lacks the mental ability to know that this man is not her husband

c. She is embarrassed about her sexual desires


4. True or false? When residents have a history of flirting with and grabbing at caregivers, it is useful to use terms like “honey” or “sweetie” with them to meet their need for attention.


a. True

b. False


5. You see Resident Brown in the lobby, in the presence of visitors, touching his exposed penis. What is your best action?


a. Close his pants and take him to a private area

b. Remove him from the area and make a joke about it to the visitors to break the tension

c. Restrain Mr. Brown so that he cannot open his pants


6. From the hallway you see Resident Lee’s husband sitting on Mrs. Lee’s bed. Although Mrs. Lee is not ambulatory, she is not mentally impaired. You notice that the two are kissing and fondling each other. What is your best action?


a. Tell them this behavior is not allowed

b. Ignore the behavior

c. Close the door to Mrs. Lee’s room so that they have privacy


Answers:

1. d 2. a 3. b 4. b 5. a 6. c


NCLEX: National Council Licensure Examination, OIIQ: Ordre des infirmières et infirmiers du Québec, OIIAQ: Ordre des infirmières et infirmiers auxiliaires du Québec

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