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In May, her husband was told that the nursing home had concluded that Mrs. Rayhons was not able to consent to sex.

At the behest of one of her daughters from a previous marriage, who had concerns, Mrs. Rayhons was moved from a private room to a shared one on May 23.

That night her room-mate pressed an alarm and told staff that Mr. Rayhons had entered the room and pulled over a curtain, and she heard suspicious noises.

The woman said: “I’m not stupid. I know what was going on.”

Nursing home staff called police and Mrs. Rayhons was taken to hospital but no signs of abuse were found. Prosecutors said they later found DNA evidence that sex had taken place.

Mr. Rayhons’s visits to his wife were limited and he last saw her on August 7. His final words to her were: “Love you honey.” She died the following day and he was arrested a week later. The Republican withdrew from a re-election race for the Iowa House of Representatives.

As the trial opened last week, prosecutors outlined how bad Mrs Rayhons’s condition had become. She had been found washing her hands in dirty lavatory water, could not remember how to eat a sandwich and believed her first husband was still alive.

Dr. John Brady, medical director of the nursing home, told the jury that if she responded positively to hugs and affection from her husband, it was a “primal response” not an “informed decision”.

He said Mrs Rayhons had scored zero on a standard test for Alzheimer’s when a score below eight counted as severe impairment. Other staff described her as being “in her own little world”.