Older adults retain the need for physical and emotional intimacy far into their later years despite the presence of cognitive impairment. The capacity to consent to sexual activity is possible for residents that can correctly recognize a potential partner, express interest in sexual activity, communicate needs and wants either verbally or nonverbally, and communicate lack of desire for sexual contact. The involvement of families in discussions of romantic relationships in the long-term care setting can be challenging but it is improved by the education and experience of providers and staff. Federal regulations regarding long-term care facilities indicate that residents have the right to engage in consensual sexual activity if they have the capacity to consent to sexual activity.

A significant percentage of older adults remain sexually active. Studies have shown that sexual activity in older adults is associated with better cognitive and mental health and better sleep. Major neurocognitive disorders are a common cause of sexually inappropriate behavior. Despite the few studies discussing sexual aspects in MNCD, existing reports indicate that up to 25% of patients suffering from Alzheimer’s disease have inappropriate sexual behavior, including increased sexual urge and hypersexuality. The ability of patients to consent to sexual relations may be underestimated by healthcare staff. Therefore, the issue of consent is an important point of discussion among staff members and each case should be assessed separately. Long-term care facilities should have policies in place that address the evaluation of a patient’s capacity to consent to sexual activity.