Over the last week, two women have come forward to accuse former president George H.W. Bush of groping them. Actress Heather Lind says the former president sexually assaulted her during a photo-op a few years ago. She spoke up because she was disappointed that former President Barack Obama shook Bush’s hand during an event that was meant to benefit hurricane victims.

Then, on Wednesday, an actress named Jordana Grolnick says that she had an experience with the ex-president that sounded a lot like Lind’s. That took place backstage at a play last summer. Lind told Deadspin that she was warned before the photo that he could get grabby. That reputation bore out, as during the photo, Bush Senior allegedly grabbed her posterior and told her that his favorite magician was “David Cop-a-feel.”

She told Deadspin that, at the time, “I just thought, ‘Whatever. He’s a dirty old man.’”

Bush Senior’s camp has released the following statement in response to the allegations. “At age 93, President Bush has been confined to a wheelchair for roughly five years, so his arm falls on the lower waist of people with whom he takes pictures. To try to put people at ease, the president routinely tells the same joke—and on occasion, he has patted women’s rears in what he intended to be a good-natured manner. Some have seen it as innocent; others clearly view it as inappropriate. To anyone he has offended, President Bush apologizes most sincerely.”

I don’t buy that explanation; it sounds to me that, based on what Lind and Grolnick have alleged, the height of his wheelchair isn’t to blame for his groping. There’s no “good-natured manner” in which one can pat a woman’s butt who did not give you permission to pat her butt. That apology makes it worse. If there were a Bad Apologies Hall of Fame, the Bush family’s bewildering statement belongs in it.

But at the same time, I’m a more than little troubled by roping George H.W. Bush and other “dirty old men” in with Harvey Weinstein or Roger Ailes or President Trump. I hate the “he’s just old” excuse; it’s been used to excuse all manner of behaviors from men. But sexually inappropriate behavior from a 93-year-old wheelchair-bound man is much different than sexually inappropriate behavior from a fiftysomething studio executive, or a person with the physical power to overcome somebody. Let’s not allow the #MeToo movement to equate an off-color joke and inappropriate touching with the sort of sexual violation that carries with it career-long consequences for women who stand up to it.

When I was in high school and early college, I worked as a nursing assistant at a nursing home. Even when the job was straightforward it was heavy stuff for a teenager: I gave baths and helped people get dressed and fed people who couldn’t feed themselves. I helped people who had lost their mobility get into and out of bed. If somebody died on my shift, I’d clean them up and help get them ready to be taken away.

A few other high school girls did the same job I did at the same facility, and the other nurses and assistants on staff looked out for us in a way that older women look out for younger women at work. They warned us that some of the elderly men in the facility would get “grabby.” Almost all of them did. That’s because sexually inappropriate behavior is common among people suffering from Alzheimer's, dementia, and other forms of age-related cognitive decline. It’s a common subject for academic study, and common fodder for advice column letter-writers distressed by it.

When I was working closely with elderly men, there’d be the odd pat on the butt while I stood at a sink to wash my hands. One man honked my breast as I was putting him into bed. Once, as I knelt at the feet of one wheelchair-bound man to put his shoes on, he put his palm on the back of my head and pushed me toward his crotch. There was a man who would masturbate in front of nurses. All of these behaviors are horrifying, but the men who were doing them were not fully in control of themselves due to cognitive decline. Sometimes families would be embarrassed or upset by the behavior of their relative, apologizing to nurses, mortified.

I was always reciprocally embarrassed to receive these apologies. Being on the receiving ends of these behaviors was distressing and upsetting, but it was impossible to tell which of them were from the patient’s own volition and which were due to the decaying state of their minds. There’s no apologizing for behavior that a person can’t help. Some dementia patients are as in control of their impulses as a diabetic is in control of their insulin.

I don’t fault Lind and Grolnick for sharing their stories, but coverage of their stories has reflected a lack of understanding of how advanced age can affect behavior. Women who have been groped by men like George H.W. Bush deserve support and respect. So do the families of people of advanced age, who are often dealing with unpleasant and out-of-character symptoms in a world sorely deficient in empathy.