Sexuality & dementia: An eLearning resource to improve knowledge and attitudes of aged-care staff

Abstract

Expression of sexuality by older people, particularly those with dementia, can be challenging and confronting for aged care staff. Education on this topic is often a low priority area for aged care organisations and there appears to be limited training programs available. Results from our study highlighted the value of an eLearning education intervention that significantly increased aged care staff and nursing students' level of knowledge relating to older people's sexuality. It also improved their attitudes and permissiveness towards late life sexuality and the expression of sexuality by people with dementia. Furthermore, respondents reported the importance of existing workplace policy (if any) on the expression of sexuality, the overall signs of wellbeing and ill-being exhibited by people with dementia, and the need for guided discussions with family members. Significant improvements in staff understanding and response towards the expression of sexuality by people with dementia may enable the facilitation of a care environment that is supportive of the verbalisation and expression of sexual preference, need and desire by people with dementia. This can, in turn, improve quality of life, health and wellbeing for people with dementia as well as reduce potential tensions between staff-resident-family when sexual expression is considered to be inappropriate.

Is it all bleak? A systematic review of factors contributing to relationship change in dementia

“…For example, this approach may involve strengthening PWD's gender identities, and creating opportunities for shared physical affection, feelings of companionship, or sexual intimacy. While there is some work published in the area of educating aged care staff regarding sexuality and dementia (Jones and Moyle, 2016), there is limited evidence available related to intervention approaches for the dyad. Future research would benefit from a focus on the development of intervention strategies to target the shared intimacy of the dyad, in order to improve relationship quality in the dementia context.…”

Influence of Sexuality on the Health of the Elderly in Process of Dementia: Integrative Review

“…A análise dos estudos selecionados mostrou uma lacuna científica sobre a temática, visto que apenas 2,5 % foram elegíveis para responder ao objetivo proposto (23,47,48,(49)(50)(51)(52)(53). Identificou-se, ainda, que a maioria das pesquisas (75 %) abordou a sexualidade de idosos com ou sem demência que vivem em lares residenciais (23,48,(49)(50)(51)(52).…”

Staff responses to residents exposing their genitals in public in long‐term care settings: The gap between common and perceived best practices

“…Combined, they accounted for 70% of all the responses, whereas the alternative (advising the resident how to channel the behaviour) was mentioned by just 32% of participants as a common practice. These figures may reflect an “extreme cautionary stance” (Villar et al, ), which considers residents’ sexual expressions (in this case, exposing oneself) as problematic behaviours that both complicate the provision of care and are symptoms of an underlying illness and, consequently, should be eradicated, rather than behaviours that need to be understood (as psychosocial and person‐centred models of care would propose, Jones & Moyle, ; Steele, ). This bias towards restriction in LTC facilities is even greater among directors and technical staff, precisely the people who make decisions and have the means to influence the model of care provided by the institution.…”

“…More recently, a growing evidence base of psychosocial approaches to managing ISBs in people with dementia has developed. The perspective that is now accepted is that ISBs could be responses to contextual cues or unmet needs for intimacy that are innate, whether or not a person has dementia (Jones & Moyle, 2016;Kamel & Hajjar, 2003;Wiskerke & Manthorpe, 2018). Although there are few published and institutionally supported documents that include evidence-based behavioural recommendations for managing ISBs, some potentially useful strategies have been proposed as either stand-alone or supplemental interventions (International Longevity Centre -UK, 2011;Kettl, 2008;Syme, Lichtenberg, & Moye, 2016;Verdelho & Gonçalves-Pereira, 2017).…”