Striking the balance: applying a human rights approach to consent for people with dementia in residential aged care

Older people are often stigmatised as sexless individuals. This perception, and the increasing need for care as people age, means that many older people are subjected to prejudices when entering residential aged care facilities, and denied opportunities for sexual expression. This paper considers the often-forgottenhuman dignity of people with dementia in aged care facilities and the need to provide opportunities for sexual expression. The paperconsiders the broad capacity spectrumfor older people with cognitive impairments and the difficulties of assessingdecision-making abilities. Drawing on international human rights instruments, the paper identifies rights to intimacy and sexual expression, and argues that those rights should be recognised in reforms to aged care legislation and policy. The paper examines some of the existing barriers to intimacy and sexual expression in aged care, including staff attitudes, and, taking NSW as an example,theexisting criminal legislation which provides a narrow viewof consent.Recommendations are made with respect to emphasising the intrinsic benefits of intimacy and sexual expression for all people, regardless of age or cognitive impairment.