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Older People’s Understandings of Sexuality (OPUS) Dr Paul Simpson Dr Laura Brown 1.

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Presentation on theme: "Older People’s Understandings of Sexuality (OPUS) Dr Paul Simpson Dr Laura Brown 1."— Presentation transcript:

1 Older People’s Understandings of Sexuality (OPUS) Dr Paul Simpson paul.simpson-2@manchester.ac.uk Dr Laura Brown laura.brown@manchester.ac.uk 1

2 Why do the research? 1. Neglected topic. Sex, intimacy & sexuality designed out of policy & everyday practice concerning older people – silenced, sidelined, especially LGB&T service users (Hafford-Letchfield 2008). 2. Need to address older people’s exclusion from ‘sexual citizenship’ (Bauer et al 2014; Gott 2005). Some literature challenges stereotypes of later life (Gilleard & Higgs 2000) BUT still coy about sex & intimacy. 3. Sexuality a human rights issue but eclipsed by concern with bio-medical & psychological functioning (Bauer et al 2014). If acknowledged often heteronormative (Willis et al 2013).. 2

3 Context: older people in UK How many? 10.3 million people aged 65 or over in the UK - 4.5% in care homes (ONS 2011) but this is still just over 500,000 (often connected) individuals. Mainly women - ratio of men to women aged 65+ in UK, 2010 was 100: 154. (ONS 2011a). Among 85+, women outnumber men by a factor of 2:1 (Office for National Statistics: 2011b). Can be exacerbated by (intersecting) inequalities of longevity by class and race. 3

4 How were accounts generated? Research consultative, participatory & feasibility study underpinned by 2 research questions: 1) how significant is this work; 2) & if important, how should it be done? 1. Semi-structured interviews in 2 care homes in NW England - 3 residents (1 woman; 2 men) and three spouses (all female). Gender-matched & used scenarios & images of intimacy & affection (opposite and same-sex). All white, British and none identified as LGBT from their accounts. 2. Focus groups 2 in 2 homes in Northwest - used scenarios & images. 1 group of ten, 1 group of six (N = 16). Included managers, dementia specialists, care & reception staff. 3. Consultative conference of 40+ academics and professional carers, including members of the Care Homes Research Group. Used as testbed for ideas from 1 & 2. 4

5 Residents’ view 1: Don’t Do It! Paul: What do you think sexuality means to residents? William (78): Negative... Nobody talks about it... Nobody practices it. We just live as we are... That’s it. We’ve had our sex life way back... Have you had a look around here at some of these [people]? They’re that bloody old, they’ve got cobwebs on ‘em... I think you should leave it alone. It’s people’s personal life. 5

6 Residents’ 2: proceed with caution & sensitivity Olivia: Well it’s just togetherness... If you’ve been married for a long, long time they need each other, even if it’s to hold hands and have a cuddle... It’s just support isn’t it; it’s just knowing that somebody’s there for you... It’s a very private thing... I don’t want anybody to know what I did or did not do.... Honour somebody’s privacy, if their door’s shut; is it shut for a reason... I know in this home there are double rooms but there’s not many. We can’t even have a cuddle lying down... Do you still have appetites James ? John (62): Do bears shit in the woods? [BUT, later]...You’re tackling the wrong age group. 6

7 Residents’ 3: in context of various needs Maria: what do you think sexuality means to residents? Emily (80yrs): Not a lot... Well it’s one of those things with older people, that they might’ve forgotten what it were like or can’t be bothered... I suppose if you became friendly with one (another resident), things might change [my emphasis]. But, as far as I’m aware there’s no double rooms here... You’ve got to remember this generation, like mine... you had your husband and you stopped. For our generation, it [sex] was like taboo...They’ve got children and grandchildren; they’ve got enough on their plate... Some women are glad when it’s finished, other women aren’t... 7

8 Partners’ Views Intimacy essential for relationship Joan: But to me, it’s just a way of showing my husband that I still love him and I still want to hold his hand and kiss him Human need for intimacy Joan: I just think people are looking for the sense that they’re loved and that they’re touched and they’re kissed and all that. Mavis: I couldn’t express enough to you what it means for these patients to be hugged What is ‘right’? Joan: We’re husband and wife, if I want to sit on my husband’s knee, I’ll sit on my husband’s knee. Mavis: It’d be nice to sort of to, I don’t know, say lie on the bed with him and just give him a hug. But now it wouldn’t be right. Other issues e.g. Youell (2014) ‘Traumatic’ transition in intimacy Fear of ‘secret’ sexuality being revealed 8

9 Care Staff Views Sexuality/intimacy needs are common and important Many grey areas – lack of clear policy Consent Altered behaviour Professionalism, safeguarding, risk-management etc. Barriers of environment Intimacy is ‘designed out’ Hard to talk about – taboos/misunderstandings etc Staff attitudes Karen: you know, people with disabilities can still have sex … it’s just possibly the age factor with the disability Other residents’ attitudes Family members 9

10 Summary 1. Residents’ responses vary: - don’t, its too private; - proceed but be sensitive & mindful of deep old age; - needs to be placed in context with other needs and wishes. 2. Spouses: - importance of intimacy within relationships and for individuals. - grey areas of appropriateness etc 3. Care staff: - A very important and relevant area - Need for guidance and policy that recognises complexities - Need for staff training & support - Environmental and cultural changes needed. 10

11 Recommendations 1. Specific intimacy/sexuality policy for care homes Evidence-based Developed with care staff 2. Staff training in sexuality/intimacy issues What is appropriate? Communication 3. Increase awareness of specific LGBT issues 4. ‘Normalising’ of sexuality/intimacy issues 5. Environmental enablement of sexuality/intimacy 11 OPUS research a basis for national research into older people’s sexuality/intimacy needs.

12 12 OPUS Team Paul Simpson, University of Manchester & Edge Hill University Laura Brown, University of Manchester Tommy Dickinson, University of Manchester Maria Horne, University of Bradford Christine Brown Wilson, University of Queensland, Australia. Kate Torkington, Valuing Older People, Manchester City Council. Stuart Smith, Age Concern LGB&T group, Manchester. Phillip Tinkler, DeNDRoN/NHS

13 Thank you… We welcome your questions and comments paul.simpson-2@manchester.ac.uk laura.brown@manchester.ac.uk 13

14 Groups & feedback 15-20 minutes discussion & feedback. Need scribe; timer/facilitator & rapporteur of headline points Table 1: what are the challenges, (including ethical ones), & barriers to addressing S/I in care settings and how might you address them? Table 2: what would you recommend as good/best practice in terms of meeting old(er) residents/service users to meet wishes concerning S/I? Table 4: what do you think sexuality means to different residents e.g. by gender, sexuality, class, & ethnicity? Table 5: What might guidance for care workers look like – what would be its essential ingredients and how would you go about getting residents input into this? Table 6: How would you include people with dementia/compromised ability to consent in plans to address needs for sexuality and intimacy. Table 7: What are the specific problems involved in addressing S/I in relation to LGBT residents and what recommendations would you make concerning practice? 14


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