J Med Ethics 38:609-613 doi:10.1136/medethics-2011-100453
  • Papers
    • Public health ethics

Dementia, sexuality and consent in residential aged care facilities

Press Release
  1. Michael Bauer
  1. Australian Centre for Evidence-Based Aged Care (ACEBAC), La Trobe University, Bundoora, Australia
  1. Correspondence to Laura Tarzia, Australian Centre for Evidence-Based Aged Care (ACEBAC), Level 5, Health Sciences 2, La Trobe University, Bundoora, Victoria, Australia; l.tarzia{at}
  1. Contributors LT, DF and MB all contributed to the conception of the paper, drafting process, critical review and final approval of the version to be published.

  • Received 15 December 2011
  • Revised 27 April 2012
  • Accepted 29 April 2012
  • Published Online First 25 June 2012


Sexual self-determination is considered a fundamental human right by most of us living in Western societies. While we must abide by laws regarding consent and coercion, in general we expect to be able to engage in sexual behaviour whenever, and with whomever, we choose. For older people with dementia living in residential aged care facilities (RACFs), however, the issue becomes more complex. Staff often struggle to balance residents' rights with their duty of care, and negative attitudes towards older people's sexuality can lead to residents' sexual expression being overlooked, ignored, or even discouraged. In particular, questions as to whether residents with dementia are able to consent to sexual activity or physically intimate relationships pose a challenge to RACF staff, and current legislation does little to assist them. This paper will address these issues, and will argue that, while every effort should be made to ensure that no resident comes to harm, RACFs must respect the rights of residents with dementia to make decisions about their sexuality, intimacy and physical relationships.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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