Sexuality in Long-Term Care: Ethical and Practical Issues

Live event was held Thursday, April 23, 2015, 1:30-2:45 pm Eastern Time
(Second in the Mental Health and Aging Training Initiative, Series IV*)


This fourth installment in the series of webinars initiated by the Geriatric Mental Health Partnership (GMHP)--an informal, voluntary group of diverse stakeholders which focuses on geriatric mental/ behavioral health care in the Commonwealth--aims to improve communication and service coordination between the mental/behavioral health and long term care systems to facilitate timely care for older adults in the most appropriate setting. 

Lack of adequate training regarding the complex needs of an aging population with behavioral health issues has been identified as an ongoing barrier to successfully providing community-based care for these individuals. Nine previous webinars have attracted a continuously growing audience, which attests to the unmet need for this type of training. In fact, in 2012, our webinars reached 600 senior service providers and in 2013, more than 1,300 professionals benefited from our online training. The webinars delivered in the Spring of 2014 successfully reached 955 senior service providers and staff.

As the aging population continues to grow, and use of State Hospitals as the site of extended behavioral health care continues to diminish, it is essential that community-based staff and providers be prepared for the rapid growth of older adults with behavioral health and dementia-related issues. This is a key issue for workforce development as the Commonwealth prepares for the future. Effective training enables staff to more quickly identify and address behavioral health-related issues before the older adult’s condition declines further or situations escalate to possibly becoming dangerous to other frail elders (or caregivers) nearby. It also helps staff distinguish between behavioral issues which can be safely addressed at the facility (or at home) versus those which constitute a true psychiatric emergency and might require inpatient treatment.

The Centers for Medicare & Medicaid Services’ (CMS) initiative “to Improve Behavioral Health and Reduce the Use of Antipsychotic Medications in Nursing Home Residents” has made training even more urgent. Due to concern about potential harmful effects of certain psychoactive medications on older adults, particularly those with dementia, CMS has recommended staff training focusing on person-centered interventions to address problematic behaviors rather than relying on the use of medications. This training can ultimately have beneficial effects on the residents’ quality of life and functioning, in addition to enhancing the knowledge, skills, and retention of staff. All 3 webinars included in this proposal specifically address this initiative.


This webinar focused on sexuality in the aging adult and address ethical matters related to consent in those with and without dementia. 


As with previous series, the proposed training program is intended for staff and students from many levels, disciplines, and settings (both facility and community-based), including staff involved in providing long term care (e.g., nursing staff and administrators), as well as behavioral health staff who work with older adults. Additionally, staff from Adult Protective Services, home health, adult day healthcare, respite care, area agencies on aging, Emergency Department staff of acute care hospitals, hospital discharge planners, and others serving older adults could benefit from the training.


The live event was open to all and free for all. 

Attendees were required to have a computer with access to high speed internet (to view the slide presentation) and computer speakers OR access to a telephone.  Additional information was provided through the registration form.


The webinar was recorded and slides are posted on this page.  


Certificates of attendance will be issued, upon request, a week after the event.  




Andrew L. Heck, PsyD, ABPP, is a licensed clinical psychologist and Clinical Director at Piedmont Geriatric Hospital in Burkeville, Virginia.  Dr. Heck is board certified in both Clinical Psychology (2005) and Geropsychology (2013; founding member).  

As Piedmont’s Clinical Director, he is responsible for the operations of the Social Work, Psychology, Rehabilitation, Nursing, and Clinical Training departments, as well as the overall clinical operations of the hospital.  He holds clinical faculty appointments in the Departments of Gerontology, Pharmacy, and Psychology departments at Virginia Commonwealth University.  

He has testified before the United States Senate on geriatric mental health training, and he is heavily involved in national initiatives pertaining to geriatric mental health training, qualifications, and practice.  His particular areas of interest include clinical supervision, dementia evaluation, decision-making competency and capacity, behavioral treatment, and ethics in working with the elderly.

Courtney Petley, LCSW, is a Licensed Clinical Social Worker and the Director of the Psychosocial Rehabilitation Department at Piedmont Geriatric Hospital, with 11 years of experience in working with older adults.  

The majority of her work experience has been in the inpatient behavioral health setting, and she has also worked with older adults and their families in the community.   


    E. Ayn Welleford, PhDreceived her BA in Management/Psychology from Averett College, M.S. in Gerontology and PhD in Developmental Psychology from Virginia Commonwealth University. She has taught extensively in the areas of Lifespan Development, and Adult Development and Aging, Geropsychology, and Aging & Human Values. As an educator, researcher, and previously as a practitioner she has worked with a broad spectrum of individuals across the caregiving and long term care continuum.

    As Associate Professor and Chair of VCU’s Department of Gerontology, she currently works to “Improve Elder Care through Education” through her Teaching, Scholarship, and Community Engagement. Outside of the classroom, Dr. Welleford provides community education and serves on several boards and committees.
    Dr. Welleford is former Chair of the Governor’s Commonwealth of Virginia Alzheimer’s and Related Disorders Commission, as well as a recipient of the AGHE Distinguished Teacher Award. In 2011, Dr. Welleford was honored by the Alzheimer’s Association at their annual Recognition Reception for her statewide advocacy. Dr. Welleford is the author of numerous publications and presentations given at national, state and local conferences, community engagement and continuing education forums. 

    In 2012, Dr. Welleford was appointed to the Advisory Board for VCU’s West Grace Village project.  She is also the recipient of the 2012 Mary Creath Payne Leadership Award from Senior Connections, the Capital Area Agency on Aging.


    Slides can be downloaded from SlideShare or directly, from the following link: 



    You can play this in full-screen mode by pressing on the four-arrow icon located at the bottom right corner of the recording screen below.


    1. I would like to let all know that the size of your Penis really matters in your relationship or marriage. I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 4.5 inch long on erection and i am 39 years old. My wife said it was forbidden by the women of this world. My wife started sleeping with other men outside. Sometimes i will return from work without finding my wife at home and whenever i call or ask her where she was, she will always snub at me and sometimes just tell me to go get a larger dick. All this continued for a long time and it hurt me so much that i was at the edge of breaking up on the marriage till when i read about a doctor called DR.OMOHAN. online. I never thought i could smile and be in a happy marriage again if not for the help of DR.OMOHAN. I got the doctors Emails:( ) on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs cream which i use for just 8 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 10 days and to my surprise my wife keeps screaming that she love my big dick now. Now my wife no longer cheat on me, and my penis is now about 10.5 inches long on erection and off course very large round. And now my wife uses breasts, hips and bums enlargement. I and my wife are very happy for the help rendered to me by DR.OMOHAN , and i want to say a big thanks to Doctor for the help. You can contact the Doctor now on his Email:( ) Am thankful to the doctor for helping me.
      his whataspp number +2348164816038

      5 IF YOU NEED A BABY SPELLhim to solve
      get all your problem solve. No problem is too big for him to solve.