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Sexuality and Intimacy in Long-Term Care Facilities

Intimacy and physical sexual expression is a basic human right and need throughout the lifespan. Find resources to help caregivers recognize consensual intimacy, protect residents from sexual abuse and support residents’ rights.


Polices and Guidelines 


  • Sexual Abuse in Nursing Homes: What You Need to Know (September 2018)
    Issue Brief from Consumer Voice and NCEA 

  • Sexual Expression Policy Development: A Guide for Long-Term Care Facilities and Assisted Living Programs (December 2016)
    In an effort to promote awareness, acceptance, and respect of the sexual rights of older adults and individuals with disabilities, the Iowa Office of the State Long-Term Care Ombudsman, in collaboration with Disability Rights Iowa, has created a set of guidelines for developing policies that address sexual expression in long-term care environments. The material is intended to guide meaningful dialogue and contribute to effective policies and procedures for addressing sexual relationships among LTC residents and ALP tenants.

  • Striking a Balance: LTC Residents’ Sexual Rights and Diminished Capacity (2016 Consumer Voice Annual Conference)

  • Capacity to Consent to Sexual Expression in Long-Term Care (2016)
    Developed by the Office of the Iowa State Long-Term Care Ombudsman, this PowerPoint explores the complexities of defining consent amongst parties with diminished capacity and examines LTC residents’ sexual rights & strategies for  balancing resident autonomy with protection from sexual abuse.

  • Sexual Expression in Long-Term Care 
    Developed by the Office of the Iowa State Long-Term Care Ombudsman, this statement outlines the rights related to sexuality for individuals residing in long-term care. This statement provides the position of the OSLTCO, in that they support the residents and tenants in developing maximum self-reliance and independence regarding their sexual choices without restricting or regulating their behaviors.

  • Sexuality and Aging Fact Sheet (2015)
    Developed by the Office of the Iowa State Long-Term Care Ombudsman, this fact sheet is to help debunk some of the myths that surround sexuality and aging. While every individual’s situation and capacity to consent varies, the following facts may help guide meaningful dialogue about older adults and sexuality.

  • Considerations Regarding the Needs of Long-Term Care Residents for Intimate Relationships and Sexual Activity 
    Carol Scott, Kansas City, MO: Center for Practical Bioethics.2007

  • Sexuality and Intimacy in LTC Facilities - Powerpoint and accompanying handout
    Updated 2014 - Developed by Julie Button and Amy Panosh of the WI Board on Aging and LTC Ombudsman Program. Note that the consent piece of the presentation pertains only to WI case law. It is important that other states are aware of this and may need to do research on their consent laws in their state.

    • Appendix 1 – Recommendations for Addressing Resident Relationships Intimacy & Sexuality History

    • Appendix 2 – Recommendations for Addressing Resident Relationships Assessment for Consent to Physical Sexual Expressions

  • Frequently Asked Questions and Answers Related to Resident Sexual Activity 
    Colorado Department of Public Health and Environment

  • Investigative Guidelines: Resident Intimacy and Sexual Behavior 
    Developed by an interdisciplinary task force composed of providers, ombudsmen, representatives from the Alzheimer's Association and Health Facilities Division Staff, in consultation with the Guardianship Alliance, the Office of the Attorney General for the State of Colorado and STD/HIV Field Services Program of the Colorado Department of Public Health and Environment. 


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