Dementia Relationships: Promoting a rights-based approach towards sexual and intimate relationships with people living with dementia

Sexuality and relationships are vital at all stages of life, enhancing quality of life through identity, affirmation and enjoyment. For individuals living with dementia acknowledging the person as a sexual being is central to compassionate person centred care. Dementia presents unique challenges in expressing sexuality and maintaining intimate relationships but contrary to stereotypes many older adults including those with dementia remain sexually active and value their autonomy in maintaining sexual relationships. However, sexuality is often seen as a concern or a medical problem to be controlled. <br/><br/>A rapid audit of care homes in Northern Ireland, aligned with a similar audit in England examined practices, policies and staff development regarding sexuality and intimacy inn residential and community settings. Findings revealed an ad hoc and limited approach with a focus on managing behaviour rather than enabling and supporting individuals in expressing their sexual needs and maintaining intimate relationships. <br/><br/>Co-designed workshops were conducted with key stakeholders including people living with dementia and health care practitioners involved in dementia care to address the key findings from the audit. This collaboration developed an online educational resource using universal design for learning principles. The educational package has three modules that explores understanding of the terms the importance and the impact of intimacy and sexuality on those living with dementia and their partners; creating an inclusive environment and guidance on initiating conversations; issues of capacity and ensuring a rights based approach. Initial evaluation suggests that participants find the website easy to navigate and the use of real scenarios helpful. Participants agreed that the resource guided their practice in relation to sexuality, intimacy and dementia. All participants stated they would continue to use the resource and felt it enabled them to develop more inclusive practice both personally and within their organisation.