The topic came up in a carers' group when the senior nurse from a care home was describing their protocol (or rather lack of protocol) for a situation where the visiting spouse requested 'privacy' with his wife within the Home but the wife was considered to lack the capacity to consent. The staff decided to 'play it by ear' and judge whether the resident was happier or distressed after these visits.
Then someone in the group asked what would happen if it was the person in care, who lacked capacity, who was pushing for 'alone time' with their spouse. Time had run out but informal discussion over coffee revealed that everyone knew someone who was now or had been pressured in this way. No one said that they had personally suffered in this way - it was all about a neighbour, cousin, old friend.........
We have a newish Elderly Mental Health Consultant in our area. He makes a point of speaking with his patient and main carer, both together and separately, which, surprisingly. was never done before. This gives him the opportunity to gently probe for any abuse or difficulties kept hidden within the relationship. He has recognised that no-one will raise this when both partners are present. I have heard, via the Senior Psychiatric Nurse at DH's Day Therapy, that the whole team has been shocked by the abuses that have been identified using this approach, and are now in discussion as to how best to support those involved.
