I consider myself a fairly unshockable person.   However, there have been a few moments in my career when something someone has said has stopped me in my tracks for a moment.

One was when I was visiting a care home and met a daughter in one of the hallways.  She was telling me about her father, who had been an actor and was a larger-than-life character in the home. She said in quite a matter-of-fact way that her mother liked to visit him on Tuesdays and his mistress, Patricia usually came on Fridays. He had had an open marriage for many years and both women were extremely important to him.  Whilst the women were not friends, they had come to accept the situation.  His daughter then told me that she was worried that some people might judge her father for his ‘infidelity’.  This story perfectly illustrates how we can never make any assumptions about someone’s personal history. Sometimes, it is easy to forget that the 90-year-old man or woman, now very dependent on us for all aspects of care has been a passionate lover and has experienced as many of the joys, complications and heartbreaks of romance as any of us have.  

The other example was when I received a phone call from a manager in a care home, where I had been running Butterfly training sessions.  She asked me if I had a ‘risk assessment for a vibrator for a 101-year-old woman’ they were supporting.  Interestingly, the woman’s age particularly jumped out at me, and my initial response was “Wow, that’s quite an age to still be enjoying sexual experiences!”  Later, I challenged myself about why her age even came into my reaction.  It makes absolute sense that someone coming to the end of their life might find the escapist sensation of masturbation something that is both comforting and enlivening.  Masturbation is a big taboo topic for many, especially as in some religions it is considered a sin.  Yet we know that some people living with dementia lose some of their inhibitions and are more likely to masturbate more openly.   My second response was to consider why we might need a risk assessment for something so personal?  When discussing this with the manager, I realised we did owe a duty of care to ensure that we thought about any potential harm of using a sex toy, how it would be cleaned, whether any lubricant would be needed, who would know about it etc.    The way in which we wrote the risk assessment was aimed to be very respectful of the woman’s privacy and independence, whilst acknowledging it was something which we did need to think about in relation to her safety and wellbeing.

Both these examples illustrate how important it is for those working in care settings to be open minded.  Is it ageism that somehow prevents us from seeing this part of older people’s lives as it confronts our own sense of mortality?  Even if we are no longer in a sexual relationship, many of us would consider ourselves sexual and sensual beings as we have a relationship with our own bodies which is integral to our sense of self.

What are the ways in which we can open up more conversations about sexuality and intimacy and to confront our own stereotypes and taboos?  Truly person-centred care means always keeping an open mind.

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Consultant & Trainer
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