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As a result they actively discouraged and limited contact between people who might appear interested in pursuing a relationship. At one end of the spectrum is the lonely, frail, cognitively impaired older adult who has no interest in or capacity for pursuing a relationship. Adults of all ages have the capacity for and interest in romance, intimacy and sexuality. Younger groups of older adults are more likely to be married or partnered, live independently and have more active lifestyles than older cohorts, which facilitates access to sex and intimacy. For example, limited access to healthy partners because of living arrangements and imbalanced sex ratio diminishes opportunities as we age. Although limited to one city, our findings provide insight into the the challenges of resident sexuality for assisted living facilities across the country. Policies exist at the state level that hold facilities accountable for resident safety. Assisted living differs from skilled nursing facilities because they are intended to provide minimal to moderate levels of help with everyday tasks in a homelike environment that emphasizes choice and control for the residents.
We wanted to know more about opportunities for and barriers to sexual expression in this emerging environment. Multiple social and health barriers can limit opportunities to pursue sexual relationships. Living status, health concerns, desire and other factors vary widely across this spectrum. People who work in assisted living have to think about the needs of all residents in the facility and justify limitations as for the good of the whole. Older adults may experience their own or their partner's health conditions, a need for assistance with activities of daily living or the loss of a spouse. The delay perhaps reflects a historic sexism within medicine, which has often neglected to investigate the possibility that female bodies may act differently from male bodies (besides the obvious differences, for example, in reproductive health). Also of concern to administrators and staff was the health and cognitive ability of residents and how to assess the ability of residents to fully consent to sexual activity.
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