Jan 20, 2023

Barriers prevent aged care residents from enjoying intimacy

Barriers prevent aged care residents from enjoying intimacy

Older Australians living in residential aged care are often faced with barriers that prevent them from maintaining intimate relationships and sexual intimacy, a new study from La Trobe University has found.

La Trobe’s Australian Centre for Evidence Based Aged Care (ACEBAC) Professor, Deirdre Fetherstonhaugh, said there is a growing need to recognise intimacy and sexual rights for older people as Australia’s ageing population moves into aged care settings.

“Intimacy contributes to our wellbeing and extends into older age, despite cognitive or physical impairment,” explained Professor Fetherstonhaugh.

“However, unlike their community-dwelling peers, who continue to enjoy their right to sexual freedom, aged care residents often find that their right to sexual expression is hampered.”

Common barriers to intimacy in aged care settings include a lack of resident privacy, unlockable doors and the unavailability of share rooms that also have large beds for couples.

Many residents also find it difficult to establish new relationships or maintain existing ones if they are separated from a partner, while they often feel judged by other residents – and even health professionals – who hold negative views of sexuality and ageing for older people.

Professor Fetherstonhaugh said barriers and judgement ultimately lead to resident sexuality being overlooked or actively discouraged – despite the fact that past research has shown sex in old age makes people happier and healthier.

She acknowledged the challenges that staff face, however, as there is a range of unique factors within the aged care setting that influence the state of intimate relationships.

La Trobe’s research saw staff from 3,000 aged care homes surveyed to determine just how much influence they have when making decisions regarding resident relationships.

A fictional relationship between Norm and Carol was the centrepiece of the survey which asked staff how they would react to the “close, mutually satisfying relationship”.

Just 10% of aged care worker respondents said they would intervene with the relationship, with the vast majority happy to let it blossom.

But as several scenarios were pitched, staff felt more inclined to respond to concerning signs.

A whopping 89% said they would act if Norm was distressed in Carol’s presence, while 40% would speak up if they knew Norm was married and his wife lived in the community.

Staff also said they would intervene if there was family disapproval or if Norm or Carol had a cognitive impairment, something that Professor Fetherstonhaugh said often complicates relationships in older people.

“When a resident has dementia there are questions around [the] capacity to consent to intimate behaviour,” said Professor Fetherstonhaugh. 

“In such cases, staff negotiate a delicate balance between the resident’s right to sexuality and their professional duty of care.”

Limited legal guidance also provided additional challenges for staff who may or may not be aware of what role they play.

Half of the homes surveyed had written policies in place regarding sexuality, one in six had policies on sexual health, while one-third had a policy for sexual behaviour.

Professor Fetherstonhaugh said there needs to be more guidance regarding older people, their sexual decisions and their rights to intimacy.

To read the full report, visit La Trobe University’s website.

What are your thoughts on older people forming intimate and sexual relationships in aged care? Is it okay, or does it need to be monitored? Tell us in the comments!

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