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Palliative Care, Intimacy, and Sexual Expression in the Older Adult Residential Care Context: “Living until You Don’t”

Author

Listed:
  • Catherine Cook

    (School of Clinical Sciences, Auckland University of Technology, Auckland 0627, New Zealand)

  • Mark Henrickson

    (School of Social Work, Massey University, Auckland 0745, New Zealand)

  • Vanessa Schouten

    (School of Humanities, Media and Communication, Massey University, Palmerston North 4442, New Zealand)

Abstract

Commonly, frail older adults move to residential care, a liminal space that is their home, sometimes a place of death, and a workplace. Residential facilities typically espouse person-centred values, which are variably interpreted. A critical approach to person-centred care that focuses on social citizenship begins to address issues endemic in diminishing opportunities for intimacy in the end-of-life residential context: risk-averse policies; limited education; ageism; and environments designed for staff convenience. A person-centred approach to residents’ expressions of intimacy and sexuality can be supported throughout end-of-life care. The present study utilised a constructionist methodology to investigate meanings associated with intimacy in the palliative and end-of-life care context. There were 77 participants, including residents, family members and staff, from 35 residential facilities. Analysis identified four key themes: care home ethos and intimacy; everyday touch as intimacy; ephemeral intimacy; and intimacy mediated by the built environment. Residents’ expressions of intimacy and sexuality are supported in facilities where clinical leaders provide a role-model for a commitment to social citizenship. Ageism, restrictive policies, care-rationing, functional care, and environmental hindrances contribute to limited intimacy and social death. Clinical leaders have a pivotal role in ensuring person-centred care through policies and practice that support residents’ intimate reciprocity.

Suggested Citation

  • Catherine Cook & Mark Henrickson & Vanessa Schouten, 2022. "Palliative Care, Intimacy, and Sexual Expression in the Older Adult Residential Care Context: “Living until You Don’t”," IJERPH, MDPI, vol. 19(20), pages 1-18, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:20:p:13080-:d:939474
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    References listed on IDEAS

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    1. Stephanie A Chamberlain & Wendy Duggleby & Pamela B Teaster & Janet Fast & Carole A Estabrooks & Candace Kemp, 2020. "Challenges in Caring for Unbefriended Residents in Long-term Care Homes: A Qualitative Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 75(9), pages 2050-2061.
    2. Joanne Brooke & Debra Jackson, 2020. "Older people and COVID‐19: Isolation, risk and ageism," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2044-2046, July.
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