One of the joys of life rises out of relationships we develop with others. Most of us seek a partner with whom we can share, set and achieve goals, and create a family together.
Life creates challenges to these relationships through job, family membership, community involvement and illness. One of the most serious of which is the loss of intimacy due to a chronic illness or aging.
Our sexuality develops over time and is shaped by our vision and the culture around us. Maturity impacts sexuality, intimacy and sexual behavior or expression. Intimacy is the bond we have with someone we love on a much deeper lever. Mutual respect and love are an integral part of intimacy. Intimacy is dynamic! It exists between people based on the depth of a relationship.
Sexual expression includes/but is not limited to socialization, communication on a deeper level, friendship, boundaries in relationships, body awareness, human connectedness, genital interactions, assertiveness, self image, self-care, decision- making and a personal code of ethics. This is defined often by our age of development.
Diagnosis such as diabetes, arthritis, pain, cancer, cognitive impairment, bladder changes, heart disease-- along with medication side effects and hormone changes can impact intimacy. Negative stereotypes about sex and aging, sensory losses, and discrepancies between the expectations of partners in a relationship (i.e. spouses or partners) threaten intimacy and sexual expression.
Loss of intimacy can include lack of privacy, decrease in stamina, depression, fear, stress or anxiety, apathy, communication changes, and a shift in the way we express intimacy. If a spouse is caring for a partner, the whole relationship can change from a peer relationship to a caregiver/care receiver relationship where they are not necessarily equal any longer. Adding the dimension of memory loss shifts the peer relationship when the care receiver may not recognize a spouse or may have disease related behaviors that affect a loss of intimacy.
Changes in roles, physical or cognitive function, anger, recognition of a partner, fatigue, loss of peer relationship, depression, and most significantly, loss of dreams dramatically change intimacy. Caregivers report that few medical professionals/ social workers address these issues and rarely talk about them at an appointment. Discussing feelings and sexuality openly (like we discuss changes in blood pressure, eating habits, and mobility) reassures caregivers that professionals recognize this aspect of caregiving. Loss of intimacy causes as much grief as the caregiving tasks may. A caregiver’s role requires they think and do for their loved one leaving little time and energy for nurturing the intimate part of their relationship. Professionals would serve their clients well to learn to address this aspect in a sensitive and open manner.
Here are some tips for caregivers:
· Talk with a trusted friend, physician or counselor about the changes in your relationship how you feel about that
· Find new ways to spend time together (cuddling, walking, holding hands)
· Use touch as an intimate form of communication (massage, dancing, hugging, lotion rubs, etc). Touch can express compassion
· Learn new ways to physically express intimacy in your relationship (touch, cuddling, physical closeness)
· Cognitively and physical changes may require that you offer your loved one something to cuddle (a body pillow or stuffed animal)
· Remember daily what you once had with your partner
· Find creative outlets that promote your self-esteem, purpose and value in the world
· Create healthy and safe way to build understanding and express your sexuality
· Maintain your social activities and relationships
Here are some tips for professionals working in the health care field:
· Recognize intimacy/changes in partner relationships as an integral part of individual identity regardless of diagnosis
· Seek the personal information and plan ways for the patient to self-express intimacy alone or with a partner in a health facility
· Educate staff
· Provide safe and private places for partners to be intimate (use the PLISSIT model)
Our sexuality and how we express it on an intimate level are intertwined. As we age we may need assistance from our caregivers in the expression of who we are. Using these approaches will help all of us remain a fully functioning human being.
Contributed by Nancy Abrahamson, Caregiver Support Coordinator, ADRC of St Croix County.
