Wife fears she’s abusing husband with Alzheimer’s

Dear Eric: My husband of almost 60 years has Alzheimer’s. At this point, he does not know who I am other than “some nice lady” who comes to see him. I initiate and have sex with him. Our initial dating and marriage were very sexual but went on to deteriorate due to his multiple flings and affairs. By the time he was diagnosed, we had not had sex in more than 20 years.

Not that it matters, I never had any kind of affairs. He was not a very good husband, he made major decisions on his own and came and went as he pleased. He was also a bit of a bully and critical. I stayed because I didn’t think I could make it on my own. Now, with the disease, he is very sweet. My question is, am I raping him? Is this senior abuse? Much as I’m enjoying it, and he seems to also, it somehow seems wrong.

— Unknown Wife

Dear Wife: There’s a lot here so I want to be precise. While some may think that older adults with Alzheimer’s or dementia can’t consent to sex, experts in the field of gerontology disagree. In a 2023 study called “The Sexual Consent Potential Model,” researchers Nathalie Huitema, Ph.D., and Maggie Syme, Ph.D., wrote, “To thrive, we need relationships, we need touch, and we need connection. Individuals who live in nursing home settings and who may have cognitive concerns are no different.” To address this, they came up with a multi-part process for determining a person’s “various possibilities of meeting sexual and/or intimacy needs at any level of cognition.”

So, it is possible your husband is able to consent, even without the cognitive ability to recognize you. However, and this is a huge however, you’re putting yourself and him at risk if the facility where he’s being cared for doesn’t have a sexual expression policy and hasn’t evaluated his cognitive ability with respect to consent.

In 2014, an Iowa man was charged with sexual abuse of his wife because the staff at her nursing home didn’t think she had the ability to consent due to her Alzheimer’s. The law varies by state and each facility has different training and policies. So, continuing to have sex with your husband requires a lot more communication on your part.

I also fear that some of your resentment from the mistreatment you endured is playing a role in all of this. I’m sorry for the way he treated you. I don’t think this is the safe path to healing, though.

Dear Eric: My father is turning 90 this November. He lives in Las Vegas; the rest of the family lives in other states. His siblings are throwing a big celebration for him. They scheduled it on a Tuesday night. The problem is, I have very little PTO, and I don’t think it’s fair that I have to take off work for a minimum of two days.

My siblings also have similar problems with their work, but they feel like they have no

choice but to attend. I feel the party needs to be moved to a weekend, it’s the only logical solution and a way for everyone in the family to attend.

My father wants all of his children and grandchildren there and will be hurt if we don’t go. He says Vegas hotel rooms are cheaper during the week, so better for his retired siblings. I feel the party should accommodate all of his working children and grandchildren!

Should I hold my ground and not attend due to the inconvenient timing? Or cave to my siblings and use what little precious PTO I have?

— Birthday Woes