clinical focus
Sexual expression and dementia
What should care staff do when confronted with sexual expression in people with dementia?
Cindy Jones interviewed by Dallas Bastian
Sexuality is a part of life, regardless of a person’ s age or whether they have dementia.
Dr Cindy Jones from Griffith University raised this point following her study into a training program designed to improve health professionals’ knowledge about sexual expression among people with dementia.
Jones said that in long-term care settings, consultation with older people, including those with dementia, about their sexual needs and concerns is minimal or doesn’ t happen at all.
“ Often, care staff actually find it quite challenging to respond to the sexual needs of older people, including those with dementia,” she added.“ They see the expression of sexuality as a problem rather than an expression of need, and they’ re often reporting to be feeling quite uncomfortable with displays of affection or sexual behaviour by those people they’ re caring for.”
Expression of sexuality is important, Jones said, because it’ s a key attribute of an individual’ s identity. Curtailing the expression of sexuality, she added, can affect a person’ s mental wellbeing and quality of life.
To increase the awareness and understanding of intimacy, sexualities and sexual behaviours specific to people with dementia, Jones ran several education webinars.
“ Overall, from the research evidence we are receiving from health professionals and carers of those with dementia, we can see that there have been some positive shifts in both knowledge and attitude,” she said, adding anecdotal evidence suggests that aged care facilities should have this type of training due to the importance of the issue in the lives of people with dementia.
“ It’ s important, within reason, to try to support as much as possible sexual expression of older people, including those with dementia, in an aged care environment.”
Aged Care Insite spoke with Jones about the ways this can be done and the lessons shared through the webinar.
ACI: What are some common misunderstandings people hold about sexual expression in people with dementia? CJ: There is a conventional ageist view that older people are asexual and therefore without sexual needs. But talking with older people, including those with dementia, we know that they continue to be sexual beings with the capacity and the need to express their sexuality. And we know through research that the sexual rights of older people are not always supported when they are in care or in long-term care settings.
Care staff struggle with the sexual expression of older people, and dementia adds another layer of complexity, because care staff can have a paternalistic view where they’ re concerned about the cognitive capacity of older people with dementia to consent to being in a relationship.
Why is it important to improve everyone’ s understanding of this issue? Expression of sexuality is important because it is a key attribute to an individual’ s personal quality of life, even for older people or those with dementia. And it is a really significant component of the identity and also who they are as an individual. And if we try to suppress or restrict them in their expression of sexuality, it will lead to a decrease in quality of life, unhealthy interpersonal relationships, or poor self-concept of themselves, and basically it doesn’ t lead to them having a sense of integrity of who they are. In severe cases, it can lead to detrimental effects on social relationships, their self-image, as well as their mental wellbeing.
24 agedcareinsite. com. au