Taking a Person-Centered Approach to Understanding Sexual Expression among Long-term Care Residents: Theoretical Perspectives and Research Challenges

Sexual activity among older adults tends to be an uncomfortable and unaddressed topic, especially within long-term care settings where caregiver responses to sexual expression ranges from acceptance to isolation and eviction (Reingold and Burros 2004). Previous definitions of sexual expression have incorporated a broad range of behaviors including sexual intercourse, solo and partnered masturbation, oral sex, personal grooming, touch, and displays of affection, companionship, and romance (DeLamater and Karraker 2009; Hajjar and Kamel 2003a, b). Inconsistencies in responses to such behaviors cause concern regarding legal and ethical boundaries and responsibilities, and raise questions regarding whether thwarting sexual expression is a violation of residents' rights (Black et al. 2005). Given the toll on residents, caregivers, and family members, sexual expression in residential and care settings poses significant policy implications. In this paper, we suggest a theoretical perspective and identify gaps in the empirical research which must be addressed in order to support institutional strategies and ultimately, consistent and ethical caregiver responses to sexual expression among older adults in long-term care settings. Extrapolating from this specific application, discussion focuses on future directions for research and policy work related to the field of sexuality among older adults. © 2011 Springer Science+Business Media, LLC.