I have always taught doctors that evidence of sexual contact in a senior who is mentally, or physically unable to give consent is elder abuse. I told them this circumstance required a report to Adult Protective Services, but recent news has given me many more factors to consider.
A legislator was arrested and charged with marital rape after having sex with his wife in her nursing home. Her doctors had declared her incapable of consent because she suffered from advanced Alzheimer’s disease. The woman died (apparently of unrelated factors,) but even if she were still alive, she would not have been able to answer questions for the defense, or the prosecution.
We don’t know how Mrs. felt about having sex. The articles did not report whether this couple had a history of spousal violence, or forced sexual activity. Neither did the articles describe physical signs, or changes in the woman’s behavior to indicate that she was hurt, agitated, or disturbed by the contact. Agitation and other changes in behavior may be the only way an Alzheimer’s patient can react to physical, or mental discomfort. However, there is no way to know whether a calm patient is really fearful, angry, or upset; in late-stage dementia, the communication connections just aren’t there anymore.
My mother took ten years and eighteen hours to die from the Alzheimer’s disease that took her from me in pieces (See my 2014 Mother’s Day Blog: A Non-Mother’s Day.) In the seventh year of a ten-year caregiving relationship, Mother asked me, “Do I know you?” The pain was overwhelming, but as painful as dementia is for adult children, a spouse’s pain is exponentially more horrible. A spouse loses aspects of a relationship that the children never even knew about. Children aren’t privy to the shared history, little touches, inside jokes, or meaningful glances that make an intimate relationship special. Spouses lose all of that and more. They may lose a soul-mate, a help-meet, or a childhood sweetheart.
I was blessed to have a ninety-seven and ninety-five year old couple in my practice. They’d been together for seventy years. Examining them separately, I asked about the secret to staying together for so long. Their identical amused, yet sensual smiles took my breath away. They also gave exactly the same answer.
“You have to pick the right gal [guy.]”
Was the situation between the legislator and his wife a case of abuse, or was he just a grieving husband, trying to maintain a connection with the woman who’d forgotten the life they’d lived together and the love they’d shared? We will never know. What do you think?