Sexuality and consent training needed in Quebec care homes, report suggests

CHSLD caregivers should be trained to discuss sexuality with residents, according to a new report by Le Comité National d’Éthique sur le Vieillissement (CNEV).

It is one of several recommendations from “Amour, sexualité et démence en milieu d’hébergement: réflexions pour guider les pratiques,” set to come out later this year.

Quebec seniors’ minister, Marguerite Blais, is currently working on developing a national policy for the province’s long-term care facilities and asked the CNEV to produce a report that would take into account the reality and the challenges neurodegenerative diseases can pose when it comes to consent. The report explores if those with Alzheimer’s, dementia and other neurocognitive disorders can offer informed consent.

There are those who are capable of expressing themselves and those who are not, according to Dr. Sophie Zhang with CIUSSS Center-Sud-de-l’Île-de-Montréal.

“The ethical issue falls between these two categories,” said Zhang.

“We are very familiar with the idea of consent in CHSLSDs,” she added. “But… it’s the grey area in between that needs to be addressed.”

Zhang, who works in 15 CHSLDs, says each case is unique and gives the example of residents who hold hands, while some can go further. Staff should pay particular attention to signs that indicate a resident is feeling uncomfortable, according to Zhang.

“Sometimes the team needs to inform the family. Most of the time it goes well.”

The report also recommends creating private rooms inside the centres, which could accommodate residents whose partner lives elsewhere. Rooms in CHSLDs are often shared with two people or more in some cases.

According to Zhang, private rooms are a good idea.

“If everyone had a private, soundproof room with a closed door, they could have a private life,” she said.

“Are we going towards a Quebec where the CHSLDs will no longer have shared rooms? I hope so,” said Zhang. “It will be better for everyone and for all kinds of reasons. Single rooms would also facilitate care and help prevent infection.”

— With files from Global News’s Elizabeth Zogalis