Palliative Care, Intimacy, and Sexual Expression in the Older Adult Residential Care Context: “Living until You Don’t”

Catherine Cook (), Mark Henrickson and Vanessa Schouten
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Catherine Cook: School of Clinical Sciences, Auckland University of Technology, Auckland 0627, New Zealand
Mark Henrickson: School of Social Work, Massey University, Auckland 0745, New Zealand
Vanessa Schouten: School of Humanities, Media and Communication, Massey University, Palmerston North 4442, New Zealand

IJERPH, 2022, vol. 19, issue 20, 1-18

Abstract: Commonly, frail older adults move to residential care, a liminal space that is their home, sometimes a place of death, and a workplace. Residential facilities typically espouse person-centred values, which are variably interpreted. A critical approach to person-centred care that focuses on social citizenship begins to address issues endemic in diminishing opportunities for intimacy in the end-of-life residential context: risk-averse policies; limited education; ageism; and environments designed for staff convenience. A person-centred approach to residents’ expressions of intimacy and sexuality can be supported throughout end-of-life care. The present study utilised a constructionist methodology to investigate meanings associated with intimacy in the palliative and end-of-life care context. There were 77 participants, including residents, family members and staff, from 35 residential facilities. Analysis identified four key themes: care home ethos and intimacy; everyday touch as intimacy; ephemeral intimacy; and intimacy mediated by the built environment. Residents’ expressions of intimacy and sexuality are supported in facilities where clinical leaders provide a role-model for a commitment to social citizenship. Ageism, restrictive policies, care-rationing, functional care, and environmental hindrances contribute to limited intimacy and social death. Clinical leaders have a pivotal role in ensuring person-centred care through policies and practice that support residents’ intimate reciprocity.

Keywords: person-centred care; social citizenship; social death; sexual expression; aged residential care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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