STDs in Nursing Homes – A Shockingly Common Problem

Stereotypes suggest that STDs are primarily an issue when people are young, particularly in their 20s and 30s, as they have the time, energy, and enthusiasm to pursue new sexual relationships regularly. 

Yet, STDs certainly aren’t limited to that age group. They can occur at every stage of adult life, including among seniors. In fact, STDs are on the rise in seniors, making this a very important topic (even if it is ultra uncomfortable).  

And honestly, the pattern isn’t that surprising. Many people continue to enjoy sex well into their golden years. Some even re-discover themselves sexually, finding slower, gentler, and more bonded ways to connect sexually. 

Today, we’re looking at one specific area – STDs in nursing homes. 

The topic is important as STDs can cause health issues, particularly if undiagnosed and untreated. Plus, if STDs are prevalent within a single nursing home, it might be a sign of an underlying problem, including elder abuse. 

Why STDs Can Be Common In Nursing Homes

Opportunity

The later years of life aren’t just a time of loss and slowdown. They can also come with new opportunities, especially now that seniors no longer need to stress about going to work every day. 

Nursing homes provide an unexpected opportunity for new romantic and sexual connections, as seniors now get to connect with many people their own age. Close proximity and shared events, like mealtimes and activities, give seniors the chance to connect with each other regularly. 

It’s not surprising that some of those connections become more than just friendship. 

Some of the seniors in a nursing home will also be single, perhaps because their partner died. This also provides a chance to experience new relationships and intimacies. That opportunity might be particularly powerful for seniors who were previously in long-term monogamous marriages. 

Finally, seniors are living longer and medications can help them to enjoy a healthy sex life for much longer. 

Boredom

While nursing homes normally have organized activities and plenty for residents to do, some may still get bored. After all, they’re probably not getting out and engaging in life as much as they did in their 30s and 40s. 

Sexual intimacy isn’t an answer to boredom for everyone, but it can be for some. 

Lack of Knowledge

STDs in nursing homes aren’t always the result of more sexual activity. Sometimes the prevalence stems from ignorance instead. 

That sounds strange, doesn’t it? Surely adults would know about the various STDs, how they’re spread, and what the symptoms look like. This isn’t necessarily the case. 

Remember, today’s seniors grew up in a highly conservative environment. They likely learned much less about sex and STDs in high school than youth do these days. 

Some seniors will have also spent decades or longer in a single monogamous marriage, where STDs were never a consideration. They may have simply assumed that STDs were only an issue for young people or for those who ‘sleep around’.  

This lack of knowledge may also mean that seniors don’t know that it’s still wise to use a condom during intimate acts, even though pregnancy is no longer an issue. 

Embarrassment

Most of us find conversations about sex at least a little embarrassing and might avoid the conversations whenever we can. Sex often feels like a taboo topic. That’s even more true for seniors who grew up in a conservative environment. 

Embarrassment may mean that seniors don’t talk to their sexual partners about possible STDs and their sexual history. It could also mean that symptoms of STDs are easily missed. 

Seniors who were previously in monogamous relationships may also be making incorrect assumptions about their partners. It may be that one partner is monogamous and the other isn’t – but the issue was never discussed. 

Compromised Immune Systems

Seniors often have lower immune systems than earlier in life, which raises the risk of contracting diseases – including STDs. 

More Carelessness

Finally, some seniors may know about STDs and simply not care. 

Some simply want to enjoy their final years as much as possible, without worrying about living as long as possible. Makes sense, right? They’re going to die of something in the next 10 or 20 years, so why stress too heavily? 

While this perspective isn’t true for all seniors, it’s certainly something to consider. 

The Risks of STDs in Nursing Homes

Treatment for STDs has got progressively better. Some can even be cured entirely with antibiotics. For others, the symptoms can often be managed with the right medication. 

Yet, STDs can still be serious, particularly in nursing homes. 

STDs Can Still Cause Health Issues

While some STDs aren’t a big deal these days, others can still cause serious health issues. This is particularly true if they’re not detected or treated early on.

Genital herpes, HIV, and hepatitis B are a few examples of incurable STDs, with HIV being the most dangerous and devastating.  But, even the comparatively benign STDs can sometimes cause complications if they’re not treated. 

Complications With Other Conditions

Seniors often deal with multiple chronic conditions, such as diabetes, chronic kidney disease, Alzheimer’s disease, and osteoarthritis. These conditions can interact with each other and may require multiple medications. 

Not surprisingly, an STD may cause complications with some health conditions or medications. Some of these may be easy to miss or not well-understood, given that there are so many types of health conditions and interactions out there. 

Increased Risk of Serious Harm

What’s more, seniors could easily experience more issues as a result of STDs, as they are more susceptible to infections and complications. 

Strain on Nursing Home Staff

STDs can sometimes end up running through a nursing home, which can create a considerable amount of pressure on staff. If this happens, staff may not be able to keep up with the health issues, which could lead to more health problems. 

Any Under-Reporting Increases The Risk Of Problems

The best health outcomes come from treating STDs early, requiring seniors to talk to their health providers about them earlier. 

But… as we’ve already talked about, seniors may not recognize the symptoms of STDs and may be too embarrassed to talk about what they’re experiencing. Such patterns raise the risk that the STD doesn’t get treated and creates further complications. 

The Darker Side of STDs in Nursing Homes

While STDs often occur because consenting adults are being sexually intimate, this isn’t always the case. 

Unfortunately, elder sexual abuse is a very real risk in nursing homes and happens more often than you might expect. Women and those with dementia are the most common victims, and abuses can include anyone who engages with the victim, including staff members, visitors, and other residents.

Sexual abuse can easily lead to STDs, especially as perpetrators are unlikely to be concerned about the victim’s health.

Many cases of STDs in a single nursing home could also indicate that the nursing home is of low quality and the staff aren’t paying as much attention as they should be. 

What You Can Do

Obviously, your parents’ sex life isn’t in your control (nor should it be!), but there are steps you can take to help protect them. 

Inform Your Parent

As we’ve been discussing, ignorance about STDs is a huge risk factor for seniors. 

So, anything that informs them about the issue can make a difference. This could involve talking to your parents directly about the issue, particularly if you can find any ways to de-stigmatize conversations about sex.  

If you’re not comfortable doing this or your parent isn’t likely to listen to you – try talking to nursing home staff or their doctor. Some parents will accept health-related advice much more easily from a professional rather than you. 

The nursing home may be able to make information about STDs more visible, such as through signs and brochures. Improving discreet access to condoms can be helpful as well. 

Engage With The Nursing Home

Your parent’s living environment has a strong impact on the risk of STD exposure. This makes it important to choose a safe environment. 

You can also talk with nursing home staff about their approaches. For example, regular sexual health screenings and education can help to identify STDs early. 

Look for Signs of Sexual Abuse

Some common signs of sexual abuse in nursing homes include new or unexplained genital infections, sexually transmitted diseases, and vaginal or anal bleeding or pain. Bruises around sensitive areas, such as breasts, genitals, and inner thighs are also indications. 

However, sexual abuse does not always leave physical signs. 

You may need to look for less obvious indicators, like agitation, fear around people, avoidance of a particular person, difficulty sleeping, or fear of the dark.  

What Nursing Homes Can Do

Nursing homes should do everything in their power to reduce the risk of sexual abuse and help protect residents from STDs following consensual sex. 

Approaches include the following:

• Have a system for determining which residents have the capacity to consent to sexual relations and which ones do not. For example, some dementia patients and those with cognitive disorders may not have enough awareness of reality to be able to give consent. 
• Have processes in place to protect cognitively-limited patients from sexual abuse.
• Educate residents about the risk of STDs and the importance of protecting against them.
• Provide easy access to barrier contraception.  
• Have formal procedures and policies to prevent abuse and investigate allegations. All allegations should be thoroughly investigated and residents protected during all steps of the process.
• Train staff about sexual abuse, how it should be reported, and what steps to follow. 

Final Thoughts

No one really wants to talk about seniors and STDs. Yet, the topic really is important. Without sufficient education and regular testing, STDs can easily spread throughout nursing homes, leading to serious health issues.