The woman was 24 with an IQ of 40 and the man 40 years her senior when he started to take advantage of her.
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He had known the woman since she was 9, and he was fully aware of her intellectual limitations, a court has heard.
Her intellectual disability meant she could not consent to sex.
"Masquerading as a quasi-carer, the offender took advantage of [the woman] for over three years to satisfy his own sexual appetite," sentencing judge Michael Elkaim said.
The 74-year-old man pleaded guilty in the ACT Supreme Court to 13 charges; five of rape and eight of an act of indecency.
He would touch the woman and on many occasions inserted a vibrator into her, causing her to develop urinary tract infections.
The man took her for treatment for the infections but told the doctor that he did not think the woman was sexually active.
He took photos of her naked, and in once instance asked a friend of the woman, also intellectually impaired, to undress as well and took photos of the two women naked on a bed.
They also had sex, which the woman did not like but agreed to because the man would get angry if she refused.
In 2013 the woman told her mother she was having sex with the man, and the woman's aunt took the complaint to police.
In a statement later provided to court, her aunt described the trust the woman had put in the man, and how she regarded him as a father figure. She said the woman was anxious and stressed, and that she had nightmares, suicidal thoughts and panic attacks.
She had taken to washing her body with very hot water after the man had sex with her.
When he was arrested, the man said he was aware of her intellectual limitations and that they'd had a sexual relationship over three years, in which they had weekly sex. He told police, the sentencing judge observed with some incredulity, that it was "like a carer's job only I wasn't being paid for it".
The court heard the man was in poor health and had a terminal illness, which had to be considered when deciding punishment.
"On the other hand, I must take into account the nature of the offences, the effects on [the woman] and the community's abhorrence of the conduct," the judge said.
On Friday Justice Eklaim sentenced the 74-year-old man to five years jail with a non-parole period of three years.
He will be eligible for release in August 2022.
