Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-18T12:56:52.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Intimacy and sexuality of nursing home residents with dementia: a systematic review

Published online by Cambridge University Press:  10 November 2014

Tineke S. M. Roelofs ,
Katrien G. Luijkx  and
Petri J. C. M. Embregts
Tineke S. M. Roelofs*
Affiliation:
Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands Stichting Schakelring, Waalwijk, Tilburg, the Netherlands
Katrien G. Luijkx
Affiliation:
Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
Petri J. C. M. Embregts
Affiliation:
Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands Dichterbij Innovation and Science, Gennep, the Netherlands
*
Correspondence should be addressed to: Tineke S. M. Roelofs, MSc, Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands. Phone: +31630798793. Email: T.S.M.Roelofs@tilburguniversity.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Considering people with dementia, increasing cognitive, physical, and environmental impairments can impede the capacity to express and experience intimacy and sexuality. When a move to a residential (nursing) home becomes inevitable, increasing dependency can influence this even more. The aim of the review is to provide a structured overview of all elements of intimacy across the full spectrum of intimacy and sexuality in people with dementia, living in specialist residential care.

Methods:

A systematic search and review were conducted. Research published between 1990 and 2013 was identified in the electronic databases: Pubmed, PsychInfo, and Medline. Inclusion and exclusion criteria were predefined. Selected studies were assessed on quality, using the Mixed Methods Appraisal Tool.

Results:

Twelve of the 215 initially retrieved unique research publications were selected. A varied range of studies were found; these studies differed in design, research quality, searched population, and research theme. Different themes emerged: intimate and sexual behavior, knowledge and attitudes, capacity to consent and care culture, and staff training and guidelines.

Conclusions:

Although results were found in a wide range of intimate and sexual behavior, knowledge, attitudes and needs of others, and descriptions of culture in residential and nursing homes, the perspective of residents was lacking in literature. Also a “protective” care paradigm was found throughout. Future research is needed to highlight resident perspective and develop training opportunities and guidelines for care staff.

Keywords

intimacysexualitydementiaAlzheimer's diseasenursing home careinstitutionalized caresystematicreview
Type
Review Article
Information
International Psychogeriatrics , Volume 27 , Issue 3 , March 2015 , pp. 367 - 384
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Association. (2012). Alzheimer's disease facts and figures. Alzheimer's and Dementia, 8, 14–15.Google Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders 4th Ed. Text Rev (DSM-IV-TR). Washington, DC: American Psychiatric Association.Google Scholar
Archibald, C. (1998). Sexuality, dementia and residential care: managers report and response. Health and Social Care in the Community, 6, 95–101.Google Scholar
Archibald, C. (2002). Sexuality and dementia in residential care – whose responsibility? Sexual and Relationship Therapy, 17, 301–309.Google Scholar
Basson, R. (2001). Human sex-response cycles. Journal of Sex and Marital Therapy, 27, 33–43.Google Scholar
Bouman, W. P., Arcelus, J. and Benbow, S. M. (2007). Nottingham Study of Sexuality and Ageing (NoSSA II). Attitudes of care staff regarding sexuality and residents: a study in residential and nursing homes. Sexual and Relationship Therapy, 22, 45–61.Google Scholar
Bullard-Poe, L., Powell, C. and Mulligan, T. (1994). The importance of intimacy to men living in a nursing home. Archives Of Sexual Behavior, 23, 231–236.Google Scholar
Byrne, G. and Neville, C. (2010). Evidence-based care in the community. In Byrne, G. and Neville, C. (eds.), Community Mental Health for Older People (24 pp). Chatswoord, Australia: Elsevier Australia.Google Scholar
Delfos, M. F. (1994). De ontwikkeling van intimiteit. Tijdschrift voor Seksuologie, 18, 282–292.Google Scholar
De Medeiros, K., Saunders, P. A., Doyle, P. J., Mosby, A. and Van Haitsma, K. (2012). Friendships among people with dementia in long-term care. Dementia: The International Journal of Social Research and Practice, 11, 363–381.Google Scholar
Di Napoli, E. A., Breland, G. L. and Allen, R. S. (2013). Staff knowledge and perceptions of sexuality and dementia of older adults in nursing homes. Journal of Aging and Health, 25, 1087–1105.Google Scholar
Doll, G. M. (2013). Sexuality in nursing homes: practice and policy. Journal of Gerontological Nursing, 39, 30–37; quiz 38–39.Google Scholar
Dourado, M., Finamore, C., Barosso, M. F., Santos, R. and Laks, J. (2010). Sexual satisfaction in dementia: perspectives of patient and spouses. Sexual Disabilities, 28, 195–203.CrossRefGoogle Scholar
Edhlund, B. M. (2006). Pubmed Essentials: A User's guide to Smarter Searching of Medical Information. Stallarholmen, Sweden: Form & Kunskap AB.Google Scholar
Ehrenfeld, M., Bronner, G., Tabak, N., Alpert, R. and Bergman, R. (1999). Sexuality among institutionalized elderly patients with dementia. Nursing Ethics, 6, 144–149.Google Scholar
Golander, H. and Raz, A. E. (2000). The mask of dementia: images of “demented residents” in a nursing ward. In Gubrium, J. F. and Holstein, J. A. (eds.), Aging and Everyday Life. Oxford, UK: Blackwell.Google Scholar
Hajjar, R. R. and Kamel, H. K. (2004). Sexuality in the nursing home, part 1: attitudes and barriers to sexual expression. Journal of American Medical Directors Association, (Suppl.), s43–s47.Google Scholar
Harris, P. B. (2009). Intimacy, sexuality and early stage dementia. Alzheimers’ Care Today, 10, 63–77.Google Scholar
Holmes, D., Reingold, J. and Teresi, J. (1997). Sexual expression and dementia: views of caregivers: a pilot study. International Journal of Geriatric Psychiatry, 12, 696–701.Google Scholar
Hooren, V. (2011). Deviant Sexual Behavior in Dementia. Available at: http://www.dementie.be/actueel/SiteFiles/scriptie%20SVHOOREN.pdf; last accessed 10 October 2013.Google Scholar
Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O’Muircheartaihg, C. A. and Waite, L. J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357, 762–774.Google Scholar
Mayers, K. S. (1994). Sexuality and the patient with dementia. Sexuality and Disability, 12, 213–219.Google Scholar
Mayers, K. S. and McBride, D. (1998). Sexuality training for caretakers of geriatric residents in long-term care facilities. Sexuality and Disability, 16, 227–236.Google Scholar
Pace, R. et al. (2012). Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review. International Journal of Nursing Studies, 49, 47–53.CrossRefGoogle ScholarPubMed
Reingold, J. D. and Burros, N. C. S. W. (2004). Sexuality in the nursing home. Journal of Gerontological Social Work, 43, 175–186.Google Scholar
Rheaume, C. and Mitty, E. (2008). Sexuality and intimacy in older adults. Geriatric Nursing, 29, 342–349.CrossRefGoogle ScholarPubMed
Tsatali, M. S., Tsolaki, M. N., Christodoulou, T. P. and Papaliagkas, V. T. (2010). The complex nature of inappropriate sexual behaviors in patients with dementia: can we put it into a frame? Sexual Disabilities, 29, 143–156.Google Scholar
Tzeng, Y.-L., Lin, L.-C., Shyr, Y.-I. L. and Wen, J.-K. (2009). Sexual behaviour of institutionalised residents with dementia a qualitative study. Journal of Clinical Nursing, 18, 991–1001.CrossRefGoogle ScholarPubMed
Ward, R., Vass, A. A., Aggarwal, N., Garfield, C. and Cybyk, B. (2005). A kiss is still a kiss? The construction of sexuality in dementia care. Dementia: the International Journal of Social Research and Practice, 4, 49–72.Google Scholar
Weeks, D. (2002). Sex for the mature adult: health, self-esteem and countering ageist stereotypes. Sexual and Relationship Therapy, 17, 231–240.Google Scholar
World Health Organization. (2006). WHO Working Definition of Sexuality. Available at: http://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/; last accessed 8 January 2014.Google Scholar
Zeiss, A. M., Davies, H. D. and Tinklenber, J. R. (1996). An observational study of sexual behavior in demented male patients. Journal of Gerontology A, 51, M325–M329.Google ScholarPubMed