Intimacy and Sexuality in Aged Care

Intimacy and sexuality are a normal part of human life at every age. In this lesson you will learn that intimacy covers much more than sex: it includes companionship, touch, affection, feeling attractive and expressing identity. We look at how the Statement of Rights in the Aged Care Act 2024 supports older people's independence, choice, privacy, dignity and connection with the people they love. You will learn why ageist assumptions about older people and sex cause harm, and how moving into residential care or receiving care at home can make intimacy harder to maintain.

Everyone brings their own beliefs, culture and experiences to this topic. In this lesson you will reflect on how your personal values might affect the way you respond to an older person's intimacy or sexuality, and why your role is to support their choices rather than apply your own views. We look at the Code of Conduct for Aged Care and the elements that apply most directly, including respecting self determination, treating people with dignity and valuing diversity, respecting privacy and providing care free from sexual misconduct. You will also learn about professional boundaries and how to get support if a situation makes you uncomfortable.

Consent is at the heart of every intimate or sexual relationship. In this lesson you will learn what valid consent looks like: freely given, informed, specific, ongoing and able to be withdrawn at any time. We explain that decision making capacity is about a particular decision at a particular time, that it can change from day to day, and that you must never assume a person lacks capacity because of age or a diagnosis such as dementia. You will learn how supported decision making and registered supporters work, and when a concern about consent must be raised with your team leader.

Privacy is essential to intimacy, and it is also one of the rights in the Statement of Rights and an element of the Code of Conduct for Aged Care. In this lesson you will learn practical ways to protect privacy and dignity for people receiving care, such as knocking and waiting, using do not disturb signs, arranging private time and space for couples, and keeping personal information confidential. We also look at how to respond if you walk in on a private moment, and why gossip about a person's relationships or sexuality is a serious breach of trust.

Some of the older people we support are lesbian, gay, bisexual, trans and gender diverse, intersex, queer, asexual or have other identities. Many lived through a time when their relationships were criminalised, treated as an illness or had to be hidden, and some may fear the same judgement in care. In this lesson you will learn why that history matters, how to create a safe and welcoming service, and practical ways to be inclusive, such as using a person's chosen name and pronouns, recognising partners and chosen family, and never assuming someone's sexuality or gender.

Sexual expression is sometimes public, unexpected or difficult to manage, particularly for people living with dementia. In this lesson you will learn a calm, respectful approach that looks for the need behind the behaviour, such as loneliness, boredom, discomfort, a need for touch or confusion about time and place. We cover practical responses like gently redirecting, offering privacy, checking for physical causes and adjusting the environment. You will learn why shaming, scolding or restricting a person without proper assessment is not acceptable, and how to record and report behaviour so the care team can plan together.

Most intimacy in aged care is consensual and should be supported. Sometimes, though, a situation involves harm. In this lesson you will learn to recognise when sexual contact or conduct becomes a safeguarding issue, including when a person cannot or does not consent, when there is pressure or a big imbalance of power, and when a staff member is involved. We explain that unlawful sexual contact or inappropriate sexual conduct is always a Priority 1 incident under the Serious Incident Response Scheme, what you must do straight away, and how to support the person afterwards. The lesson ends with a course summary.

This case study follows Dorothy and Vikram, two residents who have grown close since Vikram moved into our home. Dorothy lives with dementia, and her son is unhappy about the relationship. The lesson shows how the team listens to the family with respect while keeping Dorothy's own wishes at the centre, how the registered nurse and team leader support her decision making, and what signs staff keep watching for. Key points: family views matter but do not override the person's choices, never assume capacity is lost, and raise any sign of distress straight away.

This case study follows Harold, who moves into residential care after thirty five years with his partner, Kevin. At first Harold introduces Kevin as a friend, because of discrimination he experienced when he was younger. The lesson shows how the team makes the couple feel safe and welcome, recognises Kevin as Harold's partner in the way Harold wishes, protects their privacy and responds when another resident makes an unkind comment. Key points: never assume, let the person lead on what is shared, and respond to disrespect calmly and firmly.