The Wild Thing With Wrinkles

For a couple of years, I did MDSs (Minimum Data Set assessments in nursing homes/SNFs- mine were used to determine Medicare reimbursement rates and care plans for SNF-skilled nursing facility- patients who were generally there for rehab and then to return home; some did end up staying permanently) in a facility that was in a town with a couple of ‘sister’ facilities within the same corporation.  We were ‘separate but friendly’. They were still competition, but part of the same overall corporate bottom line.  One of those facilities had been going through a period where the DON (Director of Nurses) was the only RN in the building… ever. So she never had a day off, and was always on call. This went on for several months (I would have bailed, God bless her). One weekend, she had asked her administrator if one of us at the facility where I worked could take call for the weekend for her- meaning if there were problems requiring RN intervention- or at least notification- someone else would do it. She needed a break.  Because of health issues and medications, I didn’t take call at the facility where I worked  (and the need to do the MDSs 5 days/week; the deadlines didn’t allow for days off following having to work the floor if staff calling in sick needed someone to cover their shift), I agreed to take call. I felt bad for their DON, and could respect the need for some time off.  I didn’t know the staff or residents over there, but knew if I ran into something strange, I could notify my administrator who could contact their administrator.   I’d be on-call from 3 p.m. Friday through 7 a.m. Monday. I held my breath and went home.

At 5 p.m. on Friday, I got a call. Two hours in… this wasn’t good.  One of the nurses was upset that one of the male residents wanted to have a ‘conjugal visit’ with one of the female residents.  OK.  And the problem was???  She didn’t think they could do that. I asked if they were both cognitively intact, and had the physician statement saying they could act on their own rights. Yep. They both did.  In that case, they were aware of their actions, and were able to make those decisions. (Had one or both of them been cognitively impaired/demented, then that is a totally different situation… no diddling in the nursing home).  She double checked my answer- I told her that it was their home…they had the right to get busy as long as they both were capable of acting on their own rights.

The nurse was still uneasy about the whole thing. She asked about the roommate. I told her she needed to find a way to keep the roommate busy, and discretely ask her to allow her roommate some private time, or find a room where the two horny ones could have some privacy.  She needed to put a sign on the door that asked everybody to knock before entering (and wait for an answer !), and not act like anything was going on that required some sort of national security clearance. They were having sex, not discussing Pentagon secrets  (though in this day and time, those lines are blurry).  The nurse was still not comfortable with the whole thing.

She told me that the horny female resident was a double amputee (legs). I wasn’t sure how that mattered given what they were wanting to do. *scratching head*  I asked her what her concern was… the response: “She doesn’t have LEGS!”.  Last I knew, legs weren’t mandatory for doing the wild thing.  I told her to have the CNAs (certified nursing assistants) help the lady into bed, make sure she was safe, and leave.  Finally, I told her that if anybody had any problem with this come Monday, tell them I’d given the OK since both residents were able to make their own decisions, and that it was their home.  They had the right to intimate relationships… legs or not. I’d heard our social workers and consultants discuss various ‘rights’ many times. I was comfortable with my decision.  Let ’em have at it.

During this whole conversation I was thinking ‘it’s 5 p.m. on Friday, and I’ve got sixty-two more hours to go….’.   I was doomed. But, the rest of the weekend was eerily quiet. NO calls from the nursing home.  I hadn’t heard of any disasters on the news involving a Hill Country nursing home, and my administrator hadn’t called me  with any concerns from their administrator.  I had wondered during that phone call on Friday if they were yanking my chain to see how I’d respond, but sometime later, I think I remember hearing that the two residents involved in doing the wild thing were, in fact, a ‘couple’.

That next Monday, back at the nursing home where I worked, I was asked how being on call had gone, and told them about the wild sex questions. They all laughed.  It was funny, but more importantly, the residents weren’t stopped from being able to make decisions in an environment where nearly everything was decided for them.  The alert, cognitively intact residents of any facility can’t be ‘banned’ from living their lives as they so choose. If they are safe, it’s not up to me- and if they’re not safe, and can act on their own rights, I have to do what I can to make things safe for them.  I don’t have to agree with their decisions (no matter what they are- sex or otherwise), but I’m not permitted to impose my ‘rules’ if they are more restrictive (or permissive) than what the state guidelines permit. Nursing home residents have rights. The facility is their only home; it’s not like they can take off to the Holiday Inn for a few hours.  I found it rather sweet that those two had found each other in an institutionalized setting, and actually wanted some ‘privacy’.  And, their DON got some time off. 🙂

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