Sex and dementia: When is a loving act abuse?

They started flirting in choir, the vivacious retiree and the grandfatherly politician, both single after the deaths of their longtime spouses.

Less than two years later, they were married in the Iowa church where they met, surrounded by a gaggle of children and grandchildren and hundreds of guests dancing the polka.

It was an unexpected second chance at love for Donna Lou Young and Henry Rayhons, both past 70 at the time of their wedding.

'They were two good people who were good together,' the couple's pastor recalled.

After a four-year battle with Alzheimer's, Donna Lou Rayhons died in a nursing home in August, four days shy of her 79th birthday. A week later, Henry Rayhons, a former Iowa state representative, was arrested on a sexual abuse charge. Prosecutors accused him of having sex with his wife while she was incapacitated by dementia.

​Henry Rayhons' trial, which begins Wednesday, is a rare and possibly unprecedented examination of a little-explored aspect of consent. While much of the discussion about rape these days swirls around the influence of drugs, alcohol and the culture on college campuses, the Rayhons case asks a different question: When is a previously consenting spouse suffering from dementia no longer able to say yes to sex?

Katherine C. Pearson, who teaches and writes about elder law at Penn State University, told Bloomberg News that this is the first case of its kind she's seen in more than 20 years of working in the field.

'Any partner in a marriage has the right to say no,' she said. 'What we haven't completely understood is, as in this case, at what point in dementia do you lose the right to say yes?'

Friends and family say that Donna Lou and Henry Rayhons, a member of the state House from 1997 until this year, were besotted with one another. She often accompanied him to the Capitol. He got a bee suit to join her in her beekeeping.

A few years into their marriage, Donna was diagnosed with early-onset Alzheimer's. She suffered headaches and forgetfulness and drove on the wrong side of the road, according to Bloomberg News.

A year ago, Donna's daughter, Linda Dunshee, took her mother out to lunch. Beneath her winter coat and blazer, Donna was wearing only a sleep teddy. Later, Donna put her hands in the toilet bowl in the restaurant bathroom, Dunshee told a state investigator.

On March 29, 2014, Donna was moved to Concord Care Center in Garner, a five-minute drive from her home. Rayhons reportedly resisted the move and clashed with Donna's daughters — both from her first marriage — over how she should be cared for.

In May 2014, Dunshee and Donna's other daughter, Suzan Brunes, met with Concord staff and drew up a care plan, according to a state affidavit. The women and doctors concluded that Donna was no longer able to consent to sex, a fact Rayhons was informed of.

Any partner in a marriage has the right to say no. What we haven't completely understood is, as in this case, at what point in dementia do you lose the right to say yes?

- Katherine Pearson

Professor, Penn State University

But a week later, surveillance video showed Rayhons spending about 30 minutes in his wife's room. When he left, he was holding her underwear, which he dropped into a laundry bag in the hallway.

Donna's roommate told nursing home staff that Rayhons had come into the room and closed a privacy curtain. She then heard noises indicating he was having sex with Donna, the affidavit said.

That night, Brunes took Donna to the hospital for a rape test, Bloomberg News reported. Her underwear and bedding were sent to a crime lab.

Shortly after, a judge approved Brunes's application to become her mother's temporary guardian. Around the same time, a state investigator showed up at Rayhons's home to interview him. In the interview, he admitted to having 'sexual contact' with his wife that day, the affidavit showed.

Donna died two months later and Rayhons was arrested a week after that. Shortly before the charges were filed, Rayhons withdrew from a race to serve a 10th term as state representative for Iowa's 8th District.

Rayhons's prominence in the area prompted the Iowa Attorney General's Office to seek to move the trial out of Hancock County, where prosecutors argued they would not be able to find an impartial jury after extensive news coverage. A judge denied the request.

A statement from Rayhons' family dismissed the notion that contact between Rayhons and his wife would be rape:

'Accusing a spouse of a crime for continuing a relationship with his spouse in a nursing home seems to us to be incredibly illogical and unnatural, as well as incredibly hurtful.'