Wednesday, 28 June 2017

Should residents in care homes have sex?

Roger Watson, Editor-in-Chief

My answer to the question that heads this entry is 'why not?' However, this entry covers an article from New Zealand by Cook et al. (2017) titled: 'Ethics, intimacy and sexuality in aged care' and published in JAN. The study on which the article is based aimed to: 'analyse the accounts of staff, family and residents to advance ethical insights into intimacy and sexuality in residential care.' Four  people, including a resident, were involved and interviewed.

With regard to the possibility of intimacy, the resident said: 'No. Couldn’t do anything here because if the door opened and somebody like [manager] walked in I’d be mortified. There are no locks on the door, as you notice. . .So there really is no privacy here at all . . .. I don’t feel like I’m home.' A care assistant expressed uncertainty about what to do with regard to sexuality: 'It [sexuality-related issues] does happen, I’ve seen it happen and nobody talks about it and, we’ve got to make a judgement call, which I have done on a few occasions. . ..and you just don’t know which is the right way . . ..'  The Registered Nurse was aware that some older people may be exploited but said: 'As long as they’re not being taken advantage of and I think for some it can open up new relationships, new caring. Again, when we talk about this everybody thinks of [penetrative] sex. . .but sometimes just to sit, cuddle, kiss, stroke, whatever, that’s more than enough for a lot of them.'

In conclusion, the authors said: 'The topic is complex: too often ageism shapes assumptions about older people’s entitlement to be intimate; where there is cognitive impairment, the debate about upholding the preferences of the “then” self or the well-being of the “now” self may result in conflict among decision-makers; proxy decision-makers may have limited knowledge of the resident’s lifetime of sexual preferences. Education and policies upholding rights may increase staff awareness beyond their own moral code. However, rigid policies may work against residents’ wellbeing. Instead, flexible responses that focus on person-centred wellbeing rather than a risk management approach are desirable.'

You can listen to this as a podcast

Reference

Cook, C., Schouten, V., Henrickson, M. and Mcdonald, S. (2017), Ethics, intimacy and sexuality in aged care. J Adv Nurs. doi:10.1111/jan.13361

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