Negotiating Sexual Autonomy in Assisted Living: Policy Gaps and Practical Strategies for Residents with Dementia

Abstract

Sexual autonomy is a critical yet often overlooked aspect of well-being in assisted living (AL) communities. This study examines the challenges faced by AL staff in supporting residents’ intimate relationships, particularly those involving individuals with dementia. Findings reveal significant policy gaps and inconsistent practices, forcing staff to rely on personal judgment, which creates ethical dilemmas concerning consent, privacy, and safety (Misaro, 2023, p. 17). Family involvement emerged as both a facilitator and barrier, depending on whether families supported or opposed residents' autonomy (Kemp et al., 2021). Additionally, staff training plays a pivotal role: those with formal training prioritize autonomy, while experienced staff often adopt risk-averse approaches (Maas & Buckwalter, 2006). Recommendations include developing comprehensive policies, enhancing staff training, and engaging families through education. Standardized frameworks for consent assessment and privacy protocols are essential for fostering supportive environments (Burgess et al., 2021). Implementing these measures can promote dignity, autonomy, and emotional well-being for AL residents.