Intimacy at End-of-Life: It should be talked about
By Patty Ayers
Anybody who knows me knows that I love to talk.
In fact, there have been times after a visit with a hospice family that I have said to myself, “Boy, I wish that I would have listened more to the patient or caregiver.” The reason I bring this up is during a recent visit with a male patient I was left speechless. This was the first time that a patient had expressed his frustrations at wanting and needing intimacy from his partner. He was not sure how and if he should broach this issue with his partner and asked me for some assistance.
Well now, I had never been asked this question before and was not sure who I should consult or even where to begin. I started researching, and as I suspected, there is very little information out there on sexuality at end-of-life.
My persistence eventually paid off and I found a wonderful article in the American Journal of Hospice and Palliative Care, Sexuality at end-of-life, which does an excellent job of addressing this issue. According to the authors, couples often feel uncomfortable asking questions about sexuality at the end-of-life. Moreover, some patients may feel that their partner will no longer desire them due to changes in their physical appearance. On the flipside, caregivers may believe that they will physically hurt their loved one by engaging in sexual activity. The authors suggest patients and caregivers turn to their hospice nurse facilitate frank but sensitive discussions to share pertinent medical information, and to suggest alternate ways of remaining intimate. She should also consider taking a “sexual history” to assist the couple in adapting to the new challenges that are experiencing.
Sexual intimacy does not only encompass sexual intercourse, but it also includes the emotional need to communicate love, tenderness, desire towards your partner and physical closeness, like holding hands. So, to the patient who challenged me with a new question, I was able to suggest the he have an open and honest conversation with his partner about his desires. He should explain that even though his body has changed his desires and love for her has not.
This may be a new topic for many; if you have any further resources to share about intimacy during hospice care, please enter them in the comments section. The article Patty referenced is:
Stausmire, J. M (2004), American Journal of Hospice and Palliative Care, Sexuality at end-of-life, Volume 21, Number 1.