Making decisions about older peoples’ expression of sexuality in residential aged care!

Professor Deirdre Fetherstonhaugh1, Ms Linda McAuliffe1

1ACEBAC, La Trobe University, Bundoora, Australia

Expression of sexuality remains important for many older people as they age, despite physical or cognitive impairment. However, older people can face many challenges when it comes to the expression of their sexuality in residential aged care facilities (RACFs). These challenges come from the residential aged care environment, staff, and residents’ families as well as the presence of dementia which raises issues around capacity to consent.

The purpose of this study was to identify what factors influence senior residential aged care staff when they make decisions regarding intimate relationships and sexual expression among residents.

The study used vignette methodology to explore reactions to a fictionalised case study of a couple – Norm and Carol – who develop a close, mutually satisfying relationship. Staff were first asked whether or not they would intervene in the relationship. Using an innovative approach, several variations to the case study were then presented to explore whether staff views about intervening changed according to level of cognitive impairment; marital status; family involvement; exhibited distress; and degree of intimacy.

The study survey was sent to all 2931 Australian residential aged care facilities and completed surveys were received from one-fifth of facilities (N = 543), representing a 19% response rate. Participants were asked to provide comment and score the degree to which factors would impact their involvement in decision-making regarding sexual expression among residents.

These findings, and the implications for older people and residential aged care services including the provision of support, will be discussed


Professor Deirdre Fetherstonhaugh is the Director of the Australian Centre for Evidence Based Aged Care (ACEBAC) at La Trobe University. Her research focuses on the translation of research evidence into practice, the ethical implications of clinical practice, decision-making for people with chronic conditions such as dementia or renal failure, sexuality and dementia, and clinical risk in aged care. Deirdre also develops and delivers education to health professionals and aged care workers.

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