Let’s talk about the S word: developing an interactive training resource to engage and meet the sexuality and intimacy needs of care home residents.


Sexuality and intimacy are important for maintaining health, wellbeing and personal identity, yet for older people, sexuality and intimacy remain taboo. Sexuality and intimacy are often the missing piece of the jigsaw in needs assessment and care provision for older care-home residents. Failing to meet such needs denies legal rights to self-expression and association (WHO, 2010) and can result in deficits in self-esteem, happiness and overall health and wellbeing (Buttaro et al, 2014). Care-home residents who identify as lesbian/gay/bisexual or transgender face additional challenges relating to judgement, discrimination or social exclusion from staff or other residents due to their non-normative sexual identity (Simpson et al., 2015).

Our work to date has identified several barriers to the expression of sexuality and intimacy that care-home residents face (Simpson et al, 2015, 2016, 2017). Barriers include a lack of privacy, the attitudes of care-home staff and family (Simpson et al 2016). Care-home staff also report a number of barriers to supporting residents with their sexuality and intimacy needs, such as a lack of knowledge of (i) the legal and ethical issues relating to consent and safeguarding, (ii) the diversity of sexuality and intimacy needs, as well as a lack of confidence in knowing how to talk about these issues with residents. This is important given that care-home staff play such a key role in helping older residents meet their multifaceted needs and are routinely confronted with complex moral dilemmas concerning sexual expression and relationships under their duty of care.

Whilst paper-based resources exist to inform staff about care-home residents’ sexual wellbeing (RCN 2011; ILC–UK 2011), these have had little impact on the ability of care-home staff to support residents’ needs. Indeed, our recent audit showed that the majority of care-home managers were either unaware of these resources, or found them unhelpful, and reported a need for more resources to support staff members’ development in this area. In a consultation exercise with care-home staff from a range of care homes, staff members unanimously explained how the written guidance currently available is too complex, overwhelming, unhelpful and not well-suited to their learning needs and environment. Therefore, there is a clear need for resources relating to the sexuality and intimacy needs of care-home residents that are specifically designed for care staff in residential and nursing homes.

In our recent consultation exercise, staff explained that they would learn better through bite-sized training that was based on real-life examples, interactive and which promoted ongoing discussion with their peers. They also felt that such training would be best delivered through a resource that was easily-accessible and could be used flexibly on a variety of electronic platforms (personal smartphones, tablet computers). Even care home staff who were unfamiliar with technology said they preferred to use digital resources that were simple and intuitive.

The overall aim of this study is to develop a practical, interactive training resource to support staff development around residents’ sexuality and intimacy needs and then pilot test it to evaluate the acceptability and feasibility to care home staff/managers.

We intend to:

1. Co-create an interactive training resource to develop knowledge, skills and confidence of care-home staff to support residents’ sexuality and intimacy needs through a series of workshops.

2. Investigate the acceptability and feasibility of the co-created, interactive resource to care-home staff/managers.


The findings from this research study will inform the development of an interactive training resource designed to help care home staff to better support their residents’ sexuality, intimacy and relationship needs and its implementation into practice.  

Publications and outputs

Simpson P, Brown L, Dickinson T, Brown Wilson C & Horne M. (2018) We’ve Had Our Sex Life Way Back’: Older Care Home Residents Sexuality and Intimacy. Ageing and Society, 38: 1478-1501. DOI: 10.1017/S0144686X17000101.

Brown L, Dickinson T, Brown Wilson C, Horne M & Simpson P (2017) Openness, inclusion, and transparency in public involvement practice: A reflective exercise to develop best practice recommendations. Health Expectations, DOI: 10.1111/hex.12609.

Simpson P, Horne M, Brown L & Brown Wilson C, Dickinson T & Torkington K (2017) Old(er) Care home residents and sexual/intimate citizenship. Ageing and Society, 37(2): 243-265. Accepted 18th August 2015. Published online: 14 October 2015 Doi: 10.1017/S0144686X15001105

Simpson P, Brown L, Dickinson T, Brown Wilson C, Horne M. The challenges and opportunities in researching intimacy and sexuality in care homes accommodating older people: a feasibility study. Journal of Advanced Nursing, 73 (1):127-137. DOI:10.1111/jan.13080

Simpson P., Horne M., Brown L, Brown Wilson C, Dickinson T & Torkington K (2015) Old(er) Care home residents and sexual/intimate citizenship. Ageing and Society, 37(2): 243-265. Doi: 10.1017/S0144686X15001105