Roger Watson, Editor-in-Chief
Sexual expression among older people remains a taboo subject and sexual expression among older people in long-term care is virtually ignored. Yet, as nurses, part of our regular assessment of patients - young and old - is about sexuality; a line we often simply leave blank in assessment forms.
This study from the USA by Syme et al. (2016) titled: 'Recommendations for sexual management in long-term care: a qualitative needs assessment' and published in JAN aims: 'To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent.' Twenty Directors of Nursing across a range of long-term care facilities were interviewed. The topics they discussed were around raising awareness of the issue, educating staff and actually carrying out initial assessments of sexuality. They also said that national guidelines were required. One interviewee said: 'I think that level of connection with another human being changes a lot about your demeanor and how you move through life and long-term care is so isolating to begin with. You’ve left your home, you’ve just enough belongings in a box to take up half of only an 80 foot room and so, so many things are lost and disconnected. But if we had a better way to maintain intimate relationships with people, that would change the perception of long-term care to some.' Another said: 'We have to realize that the residents that we have are our primary focus. Family is second. We have to stand our ground when it comes to what the residents wants versus what the family wants. And at facilities we have to have that ability to stand our ground. To know that, even if somebody took us to court, we have a better chance of winning because we are meeting the needs of the resident.'
As explained by the authors: 'Despite numerous challenges identified, all DONs interviewed in this study were supportive of sexual expression, and they had many suggestions to successfully tackle these challenges, both locally and system-wide. First and foremost is the need to address sexual expression and consent openly in LTC, which has been largely ignored due to issues such as stigma and legal worries.' In conclusion, they state: 'Sexual expression and consent among LTC residents
can no longer be ignored.'
You can listen to this as a podcast.
SYME M.L., LICHTENBERG P. & MOYE J . (2016) Recommendations for sexual expression management in long-term care: a qualitative needs assessment. Journal of Advanced Nursing doi: 10.1111/jan.13005