Ethics, intimacy and sexuality in aged care

Area of Science:

• Gerontology
• Bioethics
• Sociology of Ageing

Background:

• Ageing discourses often portray residents in residential aged care as asexual, vulnerable, and at risk of exploitation.
• Expressions of intimacy and sexuality in aged care settings may be perceived as deviant or risky, leading to unaddressed staff decision-making.
• Lack of formal policies and education complicates staff's management of sensitive issues surrounding resident sexuality.

Purpose of the Study:

• To explore ethical insights into intimacy and sexuality within residential aged care.
• To analyze the perspectives of staff, family members, and residents on these sensitive topics.

Main Methods:

• A discursive methodology was employed to identify discourses shaping meanings of intimacy, sexuality, and ageing.
• Thematic analysis was used to analyze qualitative data from semi-structured interviews with four participants.
• The study focused on qualitative data from a mixed-methods study conducted in 2015.

Main Results:

• Four key themes emerged: mediated intimate relationships and everyday ethics, self-referential morality, understanding residents' past and present, and balancing ethical priorities.
• Participants relied on personal moral judgments for decision-making, often without policy or ethics education, leading to moral uncertainty and distress.
• Staff reported conflicts regarding proxy decision-making, sometimes feeling more attuned to residents' wishes than family members.

Conclusions:

• Intimacy and sexuality are routinely managed by staff, families, and residents in aged care.
• Ethically informed education and policies can empower staff to advocate for residents.
• Improved support systems can enhance resident autonomy and the feeling of being 'at home' in residential aged care.