This paper identifies issues of concern in relation to sexual abuse of elders in all aged care residential homes and issues of concern that are most pertinent to faith-based aged care facilities. However, the conflict of the rights of residents and, at times, competing rights and the moral values of the staff that care for them is not strictly an issue that is solely of concern to faith-based aged-care facilities. The most pressing issue is cognitive impairment especially as it relates to consent, but also as far as it relates to changes in sexual appetite and the vulnerabilities of people with cognitive impairment. These issues arising from cognitive impairment are discussed along with the rights of residents in nursing homes to increased freedoms, including sexual freedoms. We note that someone living in a residential home is generally considered to have the same rights as a person living in his or her own home. That said, unlike in their own homes, residential care health professionals and care-workers are tasked not only with ensuring that residents are free to exercise their freedoms, but also with ensuring that residents are free from sexual molestation. These already difficult tasks are made more difficult because of the working conditions in most aged-care facilities, e.g. staff have onerous workloads. It is argued below that care-workers in facilities who consider their work to be a vocation or ‘calling’ are more resilient in the face of poor working conditions.However, these care-workers are often conflicted in settings in which legislation has increased the freedoms of residents in aged-care facilities and diminished the rights of workers in faith based aged-care facilities. For instance, a Catholic nursing home in Belgium was fined for refusing to allow a patient to access euthanasia services. In relation to sexual freedoms a care worker in a faith-based residential facility may have to prepare a patient for an adulterous sexual encounter, despite this practice being contrary to the values of the care-worker and the host institution1. There have been numerous recommendations regarding elder sexual abuse and changes in aged-care facilities, including, but not limited to, ensuring that facilities have workable and up-to-date internal policies and procedures and that staff are trained in these policies and procedures. This paper is focused on aged-care in residential care in Australia, particularly,in light of the current Royal Commission into Aged-Care in Australia (Royal Commission into Aged-Care Quality and Safety). However, the findings in this paper are also relevant to aged care facilities in other countries given that elder sexual abuse and matters of consent are global issues. Much of the academic literature in this paper refers to aged care in the UK and USA while the discussion of particular legal acts is focused on the Australian context.