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When we think about caring for our aging loved ones, we often focus on their physical health, nutrition, and safety. But there is one aspect of their wellbeing that rarely gets the attention it deserves. That is sexual health and intimacy. I have seen firsthand how ignoring this fundamental need can leave seniors feeling isolated and undervalued. Let’s talk about why this matters and how we can do better.
The Need for Intimacy Does Not Fade with Age
Contrary to what many people believe, the desire for connection, touch, and intimacy doesn’t disappear as we age. In fact, studies show that over 50% of adults aged 65-80 remain sexually active and consider intimacy an important part of their quality of life. Yet, for seniors in long-term care facilities, expressing these natural human needs can be incredibly challenging.
I remember visiting my uncle at his assisted living community last year. The facility was clean and well-maintained, but it felt sterile, like a place designed to meet basic needs but not to nurture the soul. Shared rooms, staff walking in without knocking, and communal spaces that offered no privacy made it nearly impossible for residents to form meaningful connections. It broke my heart to see how little consideration was given to something so deeply human.
The Barriers to Intimacy in Long-Term Care
Lack of Privacy
One of the biggest obstacles to intimacy in long-term care is the lack of private spaces. Many facilities are designed with efficiency in mind, not comfort or dignity. Shared rooms and open common areas leave little room for residents to enjoy private moments with a partner or even have a quiet conversation.
Staff Attitudes and Training
Another challenge is the discomfort many staff members feel when it comes to addressing residents’ sexual health. Without proper training, caregivers may avoid the topic altogether or even discourage expressions of intimacy. This can leave seniors feeling ashamed or misunderstood.
Family Discomfort
Families often struggle to acknowledge their loved ones as sexual beings. I have seen adult children cringe at the idea of their parents having intimate relationships, and this discomfort can trickle down to the care facility. When families discourage intimacy, it sends a message that this natural part of life is no longer valid.
Cognitive Impairment and Consent
For seniors with cognitive impairments, the issue becomes even more complex. Facilities must navigate difficult ethical questions about consent and capacity, often erring on the side of caution to avoid legal risks. While this is understandable, it can also lead to unnecessary restrictions that deprive residents of meaningful connections.
How We Can Do Better
Create Private Spaces
One of the simplest ways to support intimacy in long-term care is by creating private spaces where residents can spend time with a partner or enjoy a moment of solitude. This could be as simple as installing “do not disturb” signs or redesigning common areas to include cozy nooks for conversation.
Educate Staff
Comprehensive training can help staff overcome their discomfort and learn how to address residents’ sexual health needs with respect and sensitivity. When caregivers understand the importance of intimacy, they are more likely to create an environment that supports it.
Support Couples
For residents who are in relationships, facilities should offer couple-friendly housing options. This could mean providing double beds instead of hospital-style singles or allowing partners to share a room. Small changes like these can make a big difference in maintaining emotional and physical connections.
Develop Clear Policies
Facilities need clear, resident-centered policies that balance the right to intimacy with the need for safety. These policies should be developed with input from residents, families, and staff to ensure they are both practical and compassionate.
The Bigger Picture: Honoring Our Elders
At its core, this issue is about respect. Our elders deserve to be seen as whole human beings, with the same needs and desires as anyone else. By addressing sexual health and intimacy in long-term care, we honor their humanity and improve their quality of life.
It’s not an easy conversation to have, but it is an important one. Let us start by acknowledging that intimacy is a vital part of life at every age. Then, let us work together to create care environments that support it.
References
Bauer, M., Haesler, E., & Fetherstonhaugh, D. (2019). Let’s talk about sex: older people’s views on the recognition of sexuality and sexual health in the health-care setting. Health Expectations, 22(1), 25-32. https://doi.org/10.1111/hex.12418
Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O’Muircheartaigh, C. A., & Waite, L. J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357(8), 762-774. https://doi.org/10.1056/NEJMoa067423
Mahieu, L., & Gastmans, C. (2015). Sexuality in institutionalized elderly persons: A systematic review of argument-based ethics literature. International Psychogeriatrics, 27(3), 345-357. https://doi.org/10.1017/S1041610214002373
National Institute on Aging (NIA). (2023). Sexuality in Later Life. Retrieved from https://www.nia.nih.gov/health/sexuality-later-life
American Geriatrics Society Ethics Committee. (2016). Intimacy and sexuality in long-term care. Journal of the American Geriatrics Society, 64(10), 1935-1942. https://doi.org/10.1111/jgs.14381
Simpson, P., Horne, M., Brown, L. J., Wilson, C. B., Dickinson, T., & Torkington, K. (2017). Old(er) care home residents and sexual/intimate citizenship. Ageing and Society, 37(2), 243-265. https://doi.org/10.1017/S0144686X15001105