What to Do? Elderly Patients Sexually Harass Healthcare Staff

Greg A. Hood, MD


January 31, 2018

In This Article

Healthcare Workers Are Targets

Pinches and gropes; lewd and inappropriate comments; and unwanted kisses, hugs, and touches. These occur on a regular basis in many settings.

The #MeToo movement has rightly turned on and focused the light of civility on the dark shadows of grossly improper misbehavior. These poorly kept secrets, and the extent to which the details had previously been intentionally suppressed, are poor reflections upon those who have exhibited such misogynistic behavior.

Those engaged in patient care can be subject to such abuses as well. Examples of abuse in the medical office and among clinical colleagues, and cases of healthcare workers abusing patients, have been publicized.

However, I haven't seen much discussion about the examples of sexual abuse and misconduct by patients directed against healthcare workers. With what seems to be a greater frequency, I have lately learned about some cases of what, to the general public, may be the most surprising dynamic—that of geriatric patients acting inappropriately against healthcare workers.

Most discussions in the medical literature of sexual abuse involving elderly patients have very appropriately focused the abuse and neglect that patients receive.[1] There is one aspect of sexual and emotional abuse that is generally overlooked. Everyone is aware of Shakespeare's famous passage in As You Like It, which begins, "All the world's a stage, and all the men and women merely players. They have their exits and their entrances, and one man in his time plays many parts. His acts being seven ages."

Most pertinent in this case is "Last scene of all, that ends this strange eventful history, is second childishness and mere oblivion." In some cases of cognitive decline or brain damage, patients lose their judgment and their adult restraint, and become oblivious to the nature and manifestations of their sexual urges.

#MeToo Movement Is Surfacing Sexual Abuse by Elderly Patients

A poorly kept secret of geriatric nursing is that of sexual abuse or harassment of staff by patients. Groping, unwanted sexual advances, and similar crude behavior are fairly commonplace. Sexually inappropriate behavior has been estimated to occur in 7%-8% of patients with Alzheimer disease.[2]

This figure doesn't include other cases in patients with other organic or psychiatric conditions. Traditionally, these cases often did not rise to the level of reporting at which physicians and medical directors become aware.

However, this unwanted behavior from elderly patients is a common experience for CNAs, RNs, and other staff.[3] Historically, staff have too often been advised by peers and supervisors to "get over it and keep doing the work."[4] This is perhaps understandable, given problematic staffing ratios and workloads and, most particularly, the inherent desires of those workers who see healthcare as a calling to be additionally understanding and patient with patients.

The prevalence of that attitude seems to be changing, in my experience. Perhaps as a reverberation of the #MeToo movement, I have been told more frequently of patients exhibiting such hypersexual behavior in the past few months.


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