This is an issue that pertains to some of our parents and may soon pertain to us. And it may induce you to think about the nature of desire and love.

In 2009, in a small nursing home in Iowa, a nurse discovered a 78-year-old man in flagrante delicto with an 87-year-old woman; in the nurse’s words, he was “going to town” on her.  Both were very happy; they had often been seen together. When the nurse separated them, she received insults and kicks from the woman.

The nurse contacted the head of the nursing home.  Why? The couple both suffered from dementia. Should they be allowed to carry on this way? Were they competent to consent to sex?

Neither the administrator of the nursing home nor the head nurse saw a problem; the woman was assertive enough to voice unwillingness (and she was observed to be calmer, in general, when she was with him); and the man would not have had an erection if under coercion.  There were no threats, no injuries.  The administrator did not report the incident.

However, when state inspectors heard of it, they charged the home with failing to protect the woman (concluding she had been “sexually assaulted”), and threatened withholding Medicare and Medicaid money, which would have bankrupted the home. The man was discharged.  Too late.  The head of the nursing home and the head nurse were fired, their careers destroyed.  The home was fined. Though the woman’s son had been contacted right after the incident and had found it unobjectionable, once the woman died, the following year, her family sued the home claiming it had failed to prevent her “rape.”

The event has been carefully investigated since, and it is clear that this was consensual, even loving, sex.  Of course nursing homes fear rape of helpless victims. But this is an entirely different issue, one that promises to grow to immense proportion as the 77 MILLION Boomers–who came of age in an era of sexual freedom–grow old, and many enter nursing homes.  Ten million are expected to develop Alzheimer’s Disease.

How are caregivers to deal with people who are confused, incoherent, might not even know who they are with? One school of thought is that they simply do not have the ability to consent, so such sexual activity, fraught with danger, should be prevented. But another school is that people with severe dementia have become, in the words of one observer, “to some degree somebody else.  They’ve lost mental connections with people they loved, with much of their past, but that doesn’t rob them of their desire and their need for touching, for intimacy. Just because they confuse who they’re with, that doesn’t mean it doesn’t give them some pleasure at a time in their lives when pleasure comes at a premium.”

Involving the families of the patients can be very difficult.  Some will be very uncomfortable at the thought of their parents cavorting with people they don’t really know. Whereas others are enlightened.  The husband of former Supreme Court Justice Sandra Day O’Connor had dementia and “took up with another woman in the home he was living in. Justice O’Connor decided that this was good for him, that it made him happy. And she wanted him to be happy.”

One facility, the Hebrew Home in Riverdale, New York, long ago decided to go its own way: It encourages sex and intimacy. Its head says that he thinks its residents aren’t having enough sex.  He “believes none of the great programs they offer their residents can do anybody as much good as having a romantic relationship where somebody wakes up in the morning and can’t wait to see their boyfriend or their girlfriend.”

Some think that people with dementia should not be judged by what they might have thought or felt or done what they would have done earlier in life. Each should be thought of as “a new person who should be allowed to make new choices that makes that new person happy.”

In a sense this pertains to the choices we make while still compos mentis, in middle age: Can’t we choose to leave behind what we once did, and consider ourselves new people with different desires, to be fulfilled in ways we once considered unthinkable?

During the gathering of accomplished middle-aged women that I mentioned in my last post, Oprah asked what sex was like at this time of life.

One woman said that sex with her husband “is definitely something I savor…when I remember I have a husband.”  She has a very young child.  (This helped me define middle age, which has eluded me numerically.  I think of the middle-aged as having children who have left the home, or are about to; or as having and planning to have none.)

Another woman said, “You always hear stories of married women going to the doctor because their libido is too low.  But how come you never hear about married men going to the doctor because their libido is too high?…Why are men’s desires considered the norm? Maybe instead of us going to see doctors, they ought to see doctors to get their testosterone lowered!”

This woman preferred chocolate to sex, and was defiantly owning it.  Oprah said that this was a common attitude (about both sex and chocolate, apparently).  Husbands of these women had learned to adjust–or to keep their mouths shut.

This is consistent with a running theme in TV sitcoms–if the husband does something especially noteworthy, he will be rewarded with sex; if he screws up, he doesn’t have to be told a dry evening is in store, because he is well aware of it.

However, in conversations I’ve had with women over the years, I’ve found that this is by no means common.  (I should say that I originally met all the women in my book online, where they were, or had been, looking for romance and/or sex; they are not a neutral sample.)  Many said that when the marital bed cooled, it was more often due to the dormancy of the husband; or else it was a product of trouble between the couple.  Women did not spontaneously lose interest.

This attitude burst onto the TV scene in the 90s, in “Married With Children.”  Peg Bundy is sexually inexhaustible; her husband Al, a failed shoe salesman, is content to watch television, with his hand down his pants.  He is the one in need of ignition; she is the one always begging for action–or insulting him for the lack of it.

The show was very popular, in part because of the charming cast, and the comedic anarchy of the family relationships.  But my impression was that the sexual portrait of the couple found favor with viewers because there was a lot of truth in it–and no other show dared go there.

Oprah Winfrey convened a group of her “accomplished women friends” so she could ask them about their lives, specifically middle-aged life.  She had a number of questions, including: What are the best and worst things about being a woman?

One said something Oprah considered profound:

The best and worst things about being a woman are the same: the way we feel drawn to caring for others, and the way this impulse becomes so much larger and stronger and more consuming once we have children…  Motherhood brings with it a clear and compelling awareness of human vulnerability, and a sense of having been charged with the care of others. The dream that most women have—of having children someday, of being at the center of a family—is one of the most powerful impulses in the world, yet it is also a destroyer of dreams, of ambition, and that fact is a hard and sometimes bitter truth about being female.

I am not qualified to judge this remark.  But I have not often heard women sound bitter about motherhood, or feel it has destroyed their dreams.  Rather, they know that you can’t do everything in life, and motherhood is their choice.  I dare say that there are a good number of men who would rather log a lot more time with their kids.

It’s also possible that this woman is gnashing her teeth because she is feeling the daily pressure of motherhood.  Whereas once your family is launched into the world you can take a longer (magical?) view.  Then you imagine what your life would have been like without having children, and you’re very happy with your choice.

Comments, please.

(And no, the picture is not about middle age.  But it is about some of the good and bad things about being a woman.  And it is SUCH a great photo.)

This is unsavory actor James Woods, 66, with his 20-year-old girlfriend.  Galling though it is that someone like him can land a woman this age, isn’t it fortunate that he is out of the middle-aged dating pool?  Young ladies have the advantage in the mating game of being young and fertile; they also carry the burden of being young and stupid.