Can a Wife With Dementia Say Yes to Sex?

Donna Lou Young and Henry V. Rayhons

More than 350 people attended the wedding reception of Donna Lou Young and Henry V. Rayhons in Duncan, Iowa, on Dec. 15, 2007. Family and friends ate pork roast and danced polkas to celebrate the union of a widow and a widower, both in their 70s, who had found unexpected love after the deaths of their long-time spouses.

For the next six-and-a-half years, Henry and Donna Rayhons were inseparable. She sat near him in the state House chamber while he worked as a Republican legislator. He helped with her beekeeping. She rode alongside him in a combine as he harvested corn and soybeans on his 700 acres in northern Iowa. They sang in the choir at Sunday Mass.

“We just loved being together,” Henry Rayhons says.

Today, he’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. Through their attorney, Philip Garland, the two declined to be interviewed for this story.

Sexual assault laws years ago recognized that a spouse cannot force himself or herself upon the other. Dementia confuses the issue. People with dementia can lose past inhibitions about sex and become aggressive about seeking it. They might be unable to balance a checkbook while they’re perfectly capable of deciding whether they desire a partner’s affections.

Experts in geriatrics say that intimacy -- from a hug to a massage to intercourse -- can make dementia sufferers feel less lonely and even prolong their lives. Love complicates things further.

By many accounts, Henry and Donna Rayhons were deeply in love. Both their families embraced their marriage. The case has produced no evidence thus far that the couple’s love faded, that Donna failed to recognize her husband or that she asked that he not touch her, said Rayhons’ son Dale Rayhons, a paramedic and the family’s unofficial spokesman.

Based on evidence generated so far, state prosecutors are likely to portray Rayhons as a sex-hungry man who took advantage of a sweet, confused woman who didn’t know what month it was, forgot how to eat a hamburger and lost track of her room.

“Any partner in a marriage has the right to say no,” said Katherine C. Pearson, who teaches and writes about elder law at the Penn State Dickinson School of Law and reviewed the Rayhons case at the request of Bloomberg News. “What we haven’t completely understood is, as in this case, at what point in dementia do you lose the right to say yes?”

In interviews, Rayhons said his life and reputation are already ruined. Shortly before his arrest, he withdrew from the election that probably would have won him his 10th consecutive two-year term representing a northern Iowa district in the state House of Representatives.

Sitting in his son’s heated garage on a chilly October night, he convulses with sobs recalling the events of recent months. He says he’s most distraught about being kept from Donna during the last weeks of her life.

“My wife just died and you’re charged with something like this because you prayed by her bed,” he says. “It hurts. It really hurts.”

This story was assembled from hundreds of pages of documents filed with Iowa regulators and the Hancock County District Court in Garner as well as interviews with more than two dozen people. Geoff Greenwood, a spokesman for Iowa attorney general Tom Miller, declined to comment or make prosecutors available for interviews.

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Can a Wife With Dementia Say Yes to Sex?