E.L.D. Cornerstone.  Life in words & pictures

April 14, 2015

There is no question that Donna Lou Rayhons had severe Alzheimer’s.

In the days before being placed in a nursing home in Garner, Iowa, last year, Mrs. Rayhons, 78, could not recall her daughters’ names or how to eat a hamburger. One day, she tried to wash her hands in the toilet of a restaurant bathroom. But another question has become the crux of an extraordinary criminal case unfolding this week in an Iowa courtroom: Was Mrs. Rayhons able to consent to sex with her husband? Henry Rayhons, 78, has been charged with third-degree felony sexual abuse, accused of having sex with his wife in a nursing home on May 23, 2014, eight days after staff members there told him they believed she was mentally unable to agree to sex. It is rare, possibly unprecedented, for such circumstances to prompt criminal charges. Mr. Rayhons, a nine-term Republican state legislator, decided not to seek another term after his arrest. There is no allegation that Mrs. Rayhons resisted or showed signs of abuse. And it is widely agreed that the Rayhonses had a loving, affectionate relationship, having married in 2007 after each had been widowed. They met while singing in a church choir. The case pivots on longstanding medical and ethical concerns that will become only more pressing as the population ages and rates of dementia rise. How can anyone determine whether a person with dementia can say yes to sex? Who has the right to decide? “It really is a huge issue, and somewhere down the line we’re going to have to confront it,” said Derek Beeston, a social work professor at Staffordshire University in England who has studied sex and dementia. Mrs. Rayhons, who died in August, was placed in the Concord Care Center in March 2014, soon after one of her daughters, Linda Dunshee, was called to pick her up at the Iowa State Capitol, where Mr. Rayhons was working. Ms. Dunshee found her mother wearing lingerie and unzipped pants under her coat. Details about the case come from interviews, court records and news media reports. At the care center, Mr. Rayhons, a corn and soybean farmer, visited his wife morning and evening, sometimes praying the rosary by her bed. But documents and interviews suggest he opposed some staff recommendations, including limiting outside trips, like attending a friend’s funeral at an unfamiliar church.

Michelle Dornbier, a social worker at the center, and Dr. John Boedeker, Mrs. Rayhons’s family doctor, testified on Friday about her scores on a test to assess memory and orientation. In May 2014, she scored zero, unable to recall the words “sock,” “bed” and “blue.” But Ms. Dornbier acknowledged that Mrs. Rayhons “was always pleased to see Henry.” And Dr. Boedeker acknowledged that “intimacy is beneficial for dementia patients.” Ms. Dornbier testified that the Concord Care Center allows consensual sex between residents. But she said that on May 15, 2014, family members including Mr. Rayhons were given a “care plan” establishing simple routines for Mrs. Rayhons, including limiting outings with Mr. Rayhons, mostly to church on Sunday. 

Ms. Dornbier, prompted by what she called concerns from Mrs. Rayhons’s daughter Suzan Brunes, that Mr. Rayhons was engaging in inappropriate sexual contact, wrote at the bottom of the plan: “Given Donna’s cognitive state, do you feel she is able to give consent for any sexual activity?”

The center’s doctor, Dr. John Brady, wrote: “No.” Mr. Rayhons was told the recommendation against having sex and indicated it would not be a problem, according to Ms. Dunshee. On May 23, Mrs. Rayhons was moved from a private room to a double. That evening, her roommate reported that Mr. Rayhons drew the curtain around his wife’s bed and that sexual noises were heard. Later a security camera recorded Mr. Rayhons dropping his wife’s underwear into a hallway laundry bag after leaving her room.