Staff's reactions towards partnered sexual expressions involving people with dementia living in long‐term care facilities

Abstract

Results highlight the importance of providing staff with clear guidelines regarding the management of specific sexual situations to avoid stereotyped restrictive reactions.

Nurses’ experiences and reactions towards intimacy and sexuality expressions by nursing home residents: A qualitative study

“…There is a consensus among the participants in our study, as well as in the literature, that dementia raises specific challenges in dealing with intimate and sexual needs (Hayward et al., ; Kontos, Grigorovich, Kontos, & Miller, ; Nielsen et al., ; Roach, ; Vandrevala et al., ; Villar et al., ). As explained by the participants, residents with dementia have an increased vulnerability that exposes them to a higher risk of sexual abuse.…”

“…Such experiences often result in rejection (e.g., gossip, verbal rebukes) and/or intervention (e.g., isolation, pharmacological management). Staff's negative experiences towards residents’ manifestations of sexuality and its correlation with negative reactions have been reported in numerous studies (Ehrenfeld et al., ; Hayward, Robertson, & Knight, ; Nielsen et al., ; Roach, ; Simpson, Horne et al., ; Simpson, Brown et al., ; Villar, Celdran, Serrat, Faba, & Martinez, ; Villar, Serrat, Celdran, & Faba, ). In this regard, the study of Villar et al.…”

“…In general, the evidence suggests that expressions of mutual affection were likely to be accepted and even encouraged by the caring staff, whereas expressions of eroticism provoked rejection and intervention (Bauer, ; Ehrenfeld et al., ; Tzeng et al., ). Finally, nurses’ responses to residents’ sexual desires and needs were influenced by the institutions’ organisational ethos and by the presence or lack of specific institutional policies (Aguilar, ; Cook et al., ; Nielsen et al., ; Roach, ; Tzeng et al., ; Villar et al., ). This is clear in the study of Aguilar (), in which nurses reported that restrictive policies required them to restrict residents’ sexual needs, regardless of their own positive attitudes they may have had towards sexuality in older adults.…”

“…For example, in the study of Villar et al. () on partnered sexual expressions, it was found that nurses tended to intervene in order to prevent abuse only when one partner is affected by dementia. To the other extreme, nurses deal with relationships between two patients with dementia in a more nuanced and positive way.…”

“…For example, nursing homes are often characterised by lack of privacy (i.e., common unlockable rooms, “no‐knock” policies, lack of private areas), which exposes institutionalised older adults engaged in sexual or intimate behaviours to the gaze of others (Palacios‐Ceña et al., ; Simpson, Brown et al., ; Villar et al., ). This increases the vulnerability not only of residents but also of nurses, who are often unprepared to deal with these situations and feel powerless, and co‐residents, who may be offended by the fellow residents’ sexual manifestations (Nielsen et al., ; Tzeng et al., ; Villar et al., ). Finally, families often struggle to understand and accept their relative's sexual behaviour (Cook et al., ).…”