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After my grandmother’s second husband passed away, she grew close with a man in her retirement community. He was considerate, handy, and well-educated. He was also a man of means. He gave her extravagant gifts, including a new room on her home. We asked if she thought he would consider marriage. “Of course,” my grandmother answered. “He proposes to me all the time.” So why wouldn’t she accept? “I’ve buried two husbands. I don’t want to bury a third.” My grandmother’s suitor soon developed dementia, and forgot her long before he was buried.
My cousin Susie, who is Medicare-eligible, had a live-in boyfriend for many years. I write “had” because he recently moved out. He developed early-onset dementia, and Susie decided she was not equipped to care for him. His children have power of attorney and will take responsibility.
Susie’s decision may have been colored by seeing her father’s experience. My great-uncle Sam is in his 90s now, and lived with his girlfriend, Rosie, for over a decade. I believe questions of inheritance kept them from marrying, even though Rosie eventually took his last name. To the end, her children had power over medical decisions and such. Soon after Rosie’s death, Barbara moved in with Uncle Sam; Barbara was recently diagnosed with dementia.
This past weekend, I learned that my other grandmother — Uncle Sam’s sister, who lives in a memory care facility — has made a new gentleman friend. They sit together at meals, and appear to enjoy each other’s company very much. He calls her Dolores; she doesn’t seem to mind. Besides, she can’t remember slights for longer than 10 minutes.
Love and romance in the later years is nothing new. My wife wrote her Master’s thesis two decades ago on AIDS in the geriatric population (people who were no longer concerned about pregnancy were less well-informed about, and less careful to protect against, transmission of HIV). Today, she works in a dementia clinic. Many of the stories are tragic, but the most frustrating to me are the tales of family dysfunction. The spouses in denial; the kids who won’t work with each other, or with their parent’s partner; the long-term, unmarried consorts who decide they just can’t shoulder the responsibility of caregiving.
I don’t have statistics, but I suspect the cultural trends that have downgraded family and upgraded romance are leading people to seek a different source of companionship as they age. And new romantic arrangements among the elderly force adult children — whether formally step-siblings or not — to form blended families. They may not be living under the same roof, but they are often, without their consent, placed in situations that requires them to be joint caregivers of their romantically-entangled parents. They may need to help coordinate holidays (joint or separate), living arrangements, finances, and a whole host of other responsibilities. Blending well becomes essential — but since these are adults with their own long histories, jealousies, and resentments, not to mention their own interests — it is often more difficult. Medical care can be a particularly sticky area. It can be painful for a new partner to take a backseat as the children make life-and-death decisions for a lover.
In what must be one of the saddest cases ever, Bloomberg reports on the case of Henry and Donna Rayhons. They were married in their 70s, and both have children from previous marriages. Donna developed dementia, but Henry apparently was not accepting of reality. Concerned, Donna’s children — who had power of attorney — moved Donna to a nursing facility. Henry and Donna continued to express mutual love and affection, adoration even. But as Donna’s condition deteriorated, her children questioned whether she had the mental capacity to consent to sex.
Today, [Henry]’s awaiting trial on a felony charge that he raped Donna at a nursing home where she was living. The Iowa Attorney General’s office says Rayhons had intercourse with his wife when she lacked the mental capacity to consent because she had Alzheimer’s. She died on Aug. 8, four days short of her 79th birthday, of complications from the disease. One week later, Rayhons, 78, was arrested. He pleaded not guilty.
To convict Rayhons, prosecutors must first convince a jury that a sex act occurred in his wife’s room at the Concord Care Center in Garner, Iowa, on May 23. If prosecutors prove that, his guilt or innocence will turn on whether Donna wanted sex or not, and whether her dementia prevented her from making that judgment and communicating her wishes.
The State of Iowa vs. Henry Rayhons offers a rare look into a complex and thinly explored dilemma that will arise with increasing frequency as the 65-and-over population expands and the number of people with dementia grows. It suggests how ill-equipped nursing homes and law enforcement agencies are to deal with the nuances of dementia, especially when sex is involved. The combination of sex and dementia also puts enormous strains on family relationships, which turned out to be a critical element in the Rayhons case. His four children are supporting him. Two of Donna’s three daughters played a role in Rayhons’ investigation.
We often worry about what the rise of cohabitation and the decline of marriage means for kids and teens and young adults, but what might it mean for our parents? Culture affects us all. And as difficult as broken families can be for young children, older families can be harder to blend. Our elders, too, need care, and increasingly they grow old without sons or daughters to care for them. Our elders may be just as vulnerable as children — though in a different way — to our culture’s changing sexual mores.
Note: For the sake of privacy, I used pseudonyms.