Let's talk about sex

While most people are able to express their sexuality without fear of comment or ridicule, it’s not the same for everyone

People having sex in a care home? 

The suggestion might be shocking to some but care home residents are entitled to the same rights, choices and responsibilities they enjoyed in their previous homes. As long as they don’t impinge upon the rights of others people must, according to guidance from the RCN, be able to express their sexuality, be that in the form of a relationship or otherwise.

Yet it remains a taboo subject. Nursing staff ask the details of people’s bowel habits without embarrassment but talking about sex is more difficult for some.

Dawne Garrett, the RCN's lead for nursing older people, says it’s important for HCAs to understand the issues as they may be the first people residents choose to confide in as they see and talk to them on such a regular basis. 

HCAs may be the first people residents choose to confide in

“It’s important that residents’ sexuality or intimate relationships are accepted. If we don’t acknowledge their needs residents can become very unhappy,” she says. 

It is, of course, a sensitive subject. Relatives, other residents or family members may object to intimate relations even being talked about in care homes and the idea that residents may want to express their sexuality can make some people feel uncomfortable or embarrassed. 

The wellbeing of the individual should over-ride any feeling of discomfort but, the guidance says, it’s important to acknowledge how staff feel and if you’re concerned, you should be supported to understand your own values and assumptions.  

Privacy is a key issue too. It’s generally inappropriate for staff to discuss an individual’s situation with others, including their relatives, without the resident’s explicit consent.

Respecting individuality

Just like the general population, residents come from different backgrounds and have different preferences. Being aware of this and working inclusively with people from all cultures, in all types of relationships and all sexual orientations is essential. 

“Residents will have different lifestyles. They could be single, celibate, married, in a partnership or seeking a relationship,” says Dawne. “Whatever your personal beliefs, acknowledge their individual cultural backgrounds and beliefs and don’t judge or discriminate.” 

Inappropriate behaviour

However, in a shared home environment there’s always more than one person to consider. If, as a result of someone expressing their sexuality, someone else has their rights affected, staff must take action. So what should you do?

“Try to understand more about what might be motivating the resident’s actions,” says Dawne. “Things may seem innocent enough to start off and even be dismissed as just a bit of fun, but it’s important to be vigilant. Some behaviour that was accepted as normal in past generations may now sometimes be described as harassment.”
The RCN recommends that care home providers should develop policies that treat their residents’ sexuality with respect. If you’re uncertain about a situation, refer to the local policy and seek advice from the RCN. 

“These situations could present significant challenges for nursing staff. So it’s important to be informed and ready to discuss the issue,” Dawne adds.

More information 

What should I consider when balancing care and observation with the right to privacy? 

  • Are residents free to remain in their rooms undisturbed?
  • If they choose to lock their door, is this wish respected?
  • Do staff knock and wait to be invited into a resident’s room before entering?

Can residents watch porn?

Yes, as long as it’s viewed privately and is legal. The important issue here isn’t what staff think about this activity but rather the resident’s need to do this privately. 

Where can I find out more about this issue?

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