Inappropriate sexual behaviour observed within an older adult service: The use of the St Andrew’s Sexual Behaviour Assessment (SASBA) in formulation, intervention and outcome

Abstract

Inappropriate sexual behaviour (ISB) within older adult populations is arguably overlooked within the literature in comparison to other challenging behaviour such as aggression, yet the impact on service users and staff is equally disruptive and demanding. Additionally, there can be stigma attached to ISB. Inconsistencies in terminology and lack of measurement tools for ISB limit the degree to which such behaviour can be identified, reported and managed and as a result prevalence rates vary considerably.The St Andrew’s Sexual Behaviour Assessment (SASBA: Knight et al., 2008), based on the Overt Aggression Scale – Modified for Neurorehabilitation (OAS-MNR: Alderman et al., 1997), was conceived to increase knowledge and understanding about ISB, provide clinical information to inform treatment, and make available a means of enabling appropriate, open discussion about the subject. The scale allows continuous observations of four categories of ISB, each with four levels of severity, which were developed with reference to relevant literature.Information captured using the SASBA has been demonstrated to meaningfully contribute to a formulation about ISB, which can underpin the design of an appropriate intervention, and to measure outcome. Field data using SASBA has led to further insight about the nature of ISB within older adult populations. Clinical uses of the scale are outlined and the associated benefits and limitations are discussed.