QuestionMy brother, age 71, is in a nursing home. As with many elderly, I am sure, he has had many problems, mental and physical. He was recently diagnosed with a double hernia, so huge the doctor gasped when he saw it. He will operate. My question concerns a possible symptom. He is masturbating often and I wondered if the hernias were causing undue pressure and, subsequent, stimulation. Here is a brief history and how I came to know this: From the time he was 40, his wife refused him sexually. At about age 60, he had a massive grand mal seizure and was diagnosed with a benign brain tumor (not operable but treatable). A few years later, he got involved with prostitutes in their apartment complex and the wife packed up and left him. Now he has met a lovely woman and they plan to marry, but she has seen him masturbating in less than acceptable situations and is concerned about whether he is even aware of what he is doing. Here are the ultimate questions: Could the hernias be causing constant arousal? Or is it more apt to be a result of the brain tumor? Either way, can something be done that is not catastrophic sexually? If you cannot answer, I understand, but since I don't have a POA, I can't get anyone to even talk to me. I don't want him to lose this chance for a wonderful relationship. Thank you very much, Marylynn Stults
AnswerHi Marylynn and thanks for writing,
I think you need to request a Care Conference at the home your brother is in (this is a meeting of the Head Nurse/Unit Manager, Physician, Pharmacist, Floor Nurse, Social Worker, Dietician and any other appropriate managers at the home) to sit for 20 minutes and discuss a particular resident's current concerns. Residents and family members are generally encouraged to attend but I think in this case it would be wiser not to include your brother, or at least not at the inital gathering.
The challenge with Masturbation is there is no easy answer. There are so many possible causes and influences, we can't usually pin down one and even if we identify the cause, it doesn't make treatment any easier. You do want to follow-up with the Physician though regarding possible physical causes such as pressure from the hernia, but I doubt it's that simple.
From the very little I know from what you've said, you're probably dealing with an unconscious action related to the brain tumor and loss of social skills with cognitive impairment. If this is the case, it is VERY DIFFICULT to do anything as your brother would not be aware that he is doing it nor would he be aware there is anything worng with doing it in the Dining Room in front of others.
You're right, you do not want to be the one to approach the topic if he is even cognitively aware enough to know what you're talking about. I would suggest another gentleman, perhaps his physician, talk to him (if it is even appropriate to talk to him) and discuss appropriate times and places to masturbate. This is a very controversial topic, but in my career I've always felt there is nothing morally worng with it - I see it as people responding to a physical urge; unfortunately some cognitively impaired people loss the ability to recognise appropriate times/places to do it which leads to imbarassing situations.
If you can arrange a Care Conference then the group of you can sit and discuss the best approach. This allows for all the medical professionals to brainstorm and make sure everyone involved in your brother's care is on the same page - this is always the best way to handle any challenge so people don't give conflicting information. It is a delicate topic, but not at all uncommon in a seniors home so it's better to deal with it and make sure the people in the home are involved with and aware of the treatment plan; this would be in your brothers best interest.
I hope this helps a little and I do wish you luck.
Margot
