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Determining capacity for individuals with dementia to give sexual consent: A scoping review to guide best practice
Author(s) -
Hand Michelle Danäe,
Gibson Allison
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.047567
Subject(s) - dementia , informed consent , psychology , dilemma , extant taxon , best practice , grey literature , psychiatry , medicine , medline , clinical psychology , alternative medicine , political science , law , disease , pathology , philosophy , epistemology , evolutionary biology , biology
Background Sexual relationships in long‐term residential care facilities are common, but addressing the issue of dementia and ability to consent to sex remains unclear. Do individuals with dementia have the mental capacity to consent to sex? And how should residential facilities address the ethical dilemma of consent among individuals with dementia in consideration of their residents’ safety and right to self‐determination? The aim of this study was to review extant research on best practices for determining capacity among individuals with dementia to give consent for sexual relationships. Methods A systematic scoping review of scholarly literature was conducted using the search words “dementia,” “Alzheimer’s,” “consent,” “sexual,” and “sex” to locate articles in Academic Search Complete, ScienceDirect, Wiley Online and PubMed databases. Scholarly articles in peer‐reviewed journals were deemed eligible if they (a) explored how the issue of consent among individuals with dementia is perceived and determined, and (b) provided recommendations for future practice and research with individuals with dementia. Findings Seventeen articles met this criteria and were included in the systematic scoping review. Findings demonstrate that while much of the literature has highlighted the need for widely acknowledged explicit guidelines to determine capacity for persons with dementia to consent to sex as well as recommendations to inform organizational policy and best practices for confirming an individual’s ability to consent to sex in later life among persons with dementia. Implications The issue of determining capacity to consent remains a dilemma. One possible recommendation is to explore the process for determining capacity of persons with dementia to consent to other activities, such as research participation, to inform development of a protocol for professionals to evaluate capacity for consent to sexual relationships. Such an approach will be explored, along with several recommendations for future practice.