1. The dilemma of new relationships & intimacy
within dementia care
Esther Wiskerke and Prof. Jill Manthorpe
This study was funded by King’s College London. With gratitude to the participants and my supervisor Prof. Jill
Manthorpe of King’s College London. Ethical approval granted by PNM RESC (KCL).
* The people on the images are not related to this study and were obtained via a Google search on : older people and
sexuality, ‘ouderen’ and ‘seks’ (in Dutch)
1 Human
bonding
2 Reduced
capacity
3 The feelings
and opinions
of others
4
Expectations
of the care
home
5 Addressing
the display of
affection
6 The
solution
Limitations
 Small sample.
The views of people with dementia were not included.
Majority of the participants were female.
Possible cultural differences were not explored.
But few studies have explored this subject.
Findings
Relatives
Relatives and care
home staff had
similar views which
were summarised in
6 themes. One
participant stood
out from the general
consensus.
Looking after
each other is
doing them
good – CHW TL
3
It’s alright to be
nice and
affectionate –
relative 5
Move them, separate
them, sever the
contacts – relative 3
The manager would have to take
some action, separating them onto
two floors if they have them.
Inform the family and then it’s
really up to them to maybe move
her to a different home, if it was
my mum or dad, I would move
them to a different home – CHW
AC 5
 Light-hearted or non-physical connection
between residents is deemed to be fine, but the
moment it becomes a sexual relationship then
the decision making is more complex.
 A person with dementia expressing sexuality
and engaging in sexual behaviour with another
resident is a challenge for care homes to manage
and can be emotionally painful for families.
Conclusions
What are the views of relatives and care
workers of new relationships or sexual
intimacy between care home residents
with dementia, whilst still married to
someone else?
Research question
Methodology
 Building on a systematic review of the literature
this was a qualitative exploratory study.
 Interviews were undertaken with 8 family
carers – using a vignette to prompt discussion.
 12 staff working in 2 care homes (6 staff in
each care home) – again using the vignette.
 Interviews were transcribed and analysed using
the Framework Analysis.
Recommendations
 Further research with a more diverse sample
would benefit the discussion, what might be
best practise when a person with dementia
wishes to express their sexuality with another
resident (in the moment) and how this might
be decided to be consensual.
 Further research regarding the tension
between social norms, legal safeguards and
care home management of relationships
might help all those affected.
 Further debate regarding expressions of
sexuality which could be misconstrued as
challenging behaviour, would benefit
residents of all sexual orientations.
Background
 Sexuality as part of later life is often unacknowledged.
 Dementia impacts on daily living and affects also someone’s sexuality.
 Consent is an essential consideration when people with reduced capacity are intimate.
 Sexual expression in care homes may be seen by staff as something that ought to be treated as opposed to a need that
ought to be met.
I don’t see how
you can really say
‘no’ because they
have got
dementia. I think
that maybe that
would be
seriously
overstepping the
mark of taking
away people’s
liberties – CHW
AC 11
Care home staff