CARE facilities often deny elderly people the basic right, and one of their few remaining pleasures, to continue having sex, according to a paper published earlier this month.

Many older people, including those with early stage dementia, enjoy sex while they live at home, but this changes once they move into residential care, said the Australian authors of a paper in the Journal of Medical Ethics.

They blame a lack of privacy, age discrimination and fears about the legal implications should a patient be found mentally incompetent to give consent.

"The formation of relationships, physical intimacy and the expression of sexuality are a basic human right and a normal and healthy part of ageing," wrote the authors from the Australian Centre for Evidence-Based Aged Care.

Yet most facilities do not have formal policy guidelines or staff training aimed at allowing residents to continue being sexually active.

"Privacy remains a problem, with residents often not able to lock their doors and most rooms equipped only with single beds," said the paper. "For residents with dementia, sexuality is viewed with even greater anxiety, either being labelled 'inappropriate' or a 'challenging' behaviour or as a risk to the resident."

The team acknowledged the difficulties in determining the legal threshold for informed consent in elderly patients with dementia, but argued this should not be an excuse for denying them their rights.

"It is important to remember that dementia is defined in stages, with early or mild dementia manifesting as mild forgetfulness or confusion that is often mistaken for a normal part of ageing," they wrote. "Clearly there is a significant difference between the capabilities of a person with mild dementia and one with advanced or final-stage dementia and, therefore, a single approach to sexuality and 'people with dementia' is inappropriate."

— AFP