That's so sweet about your grandfather. You're right it was a testament
to your grandmother.  I had two residents marry once while living in
the facility.  Both were able to enough to make their wishes known and
cognitively intact at that point.  One family objected but the woman
made it clear to them it was her life and she was getting married. They
were married in the chapel/library at the facility with family,
residents, and staff present.  They shared a room until she had a
massive stroke and had to move to a SNF.  Even then staff transported
him to visit her weekly until he became demented and didn't remember
her.  What was so nice was that they were able to find each other and
share the time they did have together.

I personally do not ask sexual orientation or if the person is sexually
active t admission.   I would however, notify the responsible party who
admitted the person that facility policy was that the residents had the
right to privacy and to share whatever type relationship they wanted as
long as BOTH parties were alert, oriented and legally competent to make
the decision to participate.  Children or grandchildren would sometimes
not react well to that bit of news.  Most never considered that aspect
of their parent's lives or the possibility. Many families would be
surprised though.

I did have an administrator who made a resident cry and publicly
humiliated her for having sex with another resident. DSS cited the home
for it too.  There were medical reasons why the woman shouldn't have
had relations with that resident, BUT legally, it was none of the
administrator's business and she violated the woman's resident rights.

Evelyn, they were beyond the point that they could have been legally
considered to be "of sound mind".  It was so sad... his wife had been his
caretaker but she died of cancer, her husband had been her caretaker but he
died of heart disease.  And there wasn't anything going on beyond hand
holding and hugs.  There was a spouse shaped space reserved in their minds
and in their dementia, they decided it was each other.  I think the kids may
have overreacted because 1) they had just lost a parent and 2) no one knows
exactly how non-functional a person with dementia is until they live with
them awhile.  These two occurring at the same time seemed to have just been
the proverbial straw.  I know both were moved to different facilities and
I've wondered since if they each attached to someone else at the new place.

But I continue to be amazed at how many people continue to expect someone
with dementia to "make sense", "behave properly" or other such nonsense.
You just want to shake them and say "if they could do that, they wouldn't
have dementia!"

Karen

Agreed!  The director of the place my MIL tried to approach the subject in a
round-about manner and my hubby told him "She's been making her own
decisions about that for a long time and that's still her business" but I've
since been told that's not always the attitude people's kids take.  It may
be easier for Hubby since his parents divorced 35 years ago.  It's not an
issue of being disloyal to Dad in his mind.  maybe that's not the case when
the spouse has been in the picture more recently.

Karen

----snip----

Patty, I agree that if a relationship is consensual, it is none of
anyone else's business; not the staff and no one else.  I nearly lost
my job (well got threats of it anyway) for repeatedly having to remind
an administrator that it was NONE of her business what residents did in
privacy. I had one family member who was a physician and guardian for
her LO who wrote a letter to the facility giving consent for her LO to
have sexual relations if she chose. I found it in the resident's file
when I went to work there. But the family member was well aware of her
LO's behaviors and ability to express herself and took the added
precaution to make sure she had the right to do so if she chose.

Ensuring resident rights were not violated was part of my job just as
was investigating resident complaints.  It finally came back to bite
the administrator when the resident she made cry and publicly
humiliated in front of me and two other staff b/c the woman had sex
with another resident filed a complaint which I  documented and
completed an investigation on the way I was supposed to do. The
administrator was way out of line. No matter her personal opinions, she
had no right to express them to the resident or demean the residentr in
that manner.  In doing so, she violated that resident's rights. When
the resident (who was in her 30s)  complained to the ombudsman and DSS,
they reviewed everything and substantiated the resident's complaint.
Thankfully, I had documented it and requested I be allowed to inservice
the staff (although it was really the administrator who needed it) on
resident rights and how to deal with (or stay out of) sensitive issues.
The administrator had denied my request though which didn't put her in
a good light.

However, if  a person is mentally incompetent and incapable of giving
consent, then it is a different issue. I wasn't trying to disapprove of
what is happening in your facility..just to point out that things can
change or aren't always what they appear.  I've worked in ALFs for many
more years than I've been in SNFs and in both instances, consent has to
be in conjunction with mental competence, at least in our state.

With my MIL's situation, she and the other woman walked the halls
constantly, held hands, combed each other's hair, sang together all
day, etc.  It was after the staff caught the other woman in her bed,
holding MIL against the wall, and MIL crying that it became an issue.
That was not a consensual situation.  Whatever innocent behaviors had
gone before were not in play with that situation. In that instance, a
resident was not consenting nor actively taking part but being forced.
She was crying and being held in place.  In this case, it was the
home's (an ALF by the way) responsibility to protect her. Later down
the road, the daughter of the other resident involved let it slip that
"stuff like this is why mama keeps getting kicked out". We solved it by
moving her into a private room. A simple solution which if the daughter
had shared the information at her admission could have prevented a
trauma and regression in another resident.  Even if it hadn't been my
MIL involved, I would still have taken a stand on it b/c one resident
was not consenting.

I've seen many behaviors from residents, had my rear and chest grabbed,
had people expose themselves,hit, spit on, etc and much more over the
years.  Female resident's pulling their shirts up/off upsets some
family members, but others accept it as part of the AD behaviors as
much as wandering or taking/hording/moving objects or blaming things on
"imaginary visitors".   Behaviors are just part of working with AD
residents. That's an expected issue.  I just try to maintain their
rights and balance those with making sure no other resident's right is
violated by behaviors of others which may impact on them or to which
they can not legally consent.

I do commend you and your facility for taking cautionary measures and
addressing those issues so thoroughly.  I tend to be proactive rather
than reactive as my last two administrators were.  I'd rather
anticipate things and make sure regs are followed and rights not
violated by taking steps to ensure that before a problem arises, but I
had administrators who waited and reacted after issues arose.  Sounds
as if you have a better situation in your facility.