Elder Care and Yichud
The Torah prohibits a man and woman, who are forbidden from one another, from being secluded together. This prohibition points to an interesting discussion. It is increasingly common for elderly individuals to receive private care and aid in the comfort of their homes. This practice can potentially cause a problem of yichud between an elderly male patient and a female aid. However, there is an idea that yichud may be permitted when a man is impotent and, therefore, may be secluded with a woman.
The Shulchan Aruch (E.H. 22:11) rules: “A person may be secluded with a girl younger than the age of three and a boy younger than the age of nine as the Chachamim only decreed that Yichud is forbidden with a woman or man who is capable of sexual relations.” The Zayis Ra’anan includes this to include an elderly man incapable of sexual relations. However, a Gemara in Shabbos discusses how one may not perform castration on an elderly man who is impotent because, through medication, one’s virility may be restored. Therefore, this should also apply to the laws of yichud, which would prohibit an impotent elderly man from being secluded from a woman. The Zayis Ra’anan concludes that it would indeed be prohibited for an impotent man to be secluded with a woman.
The Tzitz Eliezer (6:40, Kuntres Issurei Yichud 22) disagrees and maintains that the prohibition of yichud surrounds the possibility of sexual relations. Therefore, it seems that he would permit yichud in the case of an elderly patient. However, he rules due to Maris Ayin, and the general isn't aware of his physical capabilities, so it should not be permitted. Rav Moshe Feinstein zt”l (Igros Moshe, E.H. 4:65:10) mostly agrees with the ruling of the Tzitz Eliezer. He additionally gives another reason for this ruling: that an older male patient can potentially rediscover his virility.
Therefore, it would seem that an impotent elderly male patient would be prohibited from being secluded with a female aid. However, Rav Elyashiv zt”l and Rav Nissim Karelitz zt”l ruled that closed-circuit television cameras can be used to circumvent the prohibition of yichud. This method has two advantages: it avoids a situation of yichud and monitors the aid’s care.