In amongst all of the practical and emotional conversations which need to be had in hospices, thinking about sex, relationships and intimacy might fall down our list of priorities. But for many people intimacy plays an important role throughout their lives, and it can be difficult to know how or if that can continue when patients are diagnosed with a life limiting condition.
“Sexuality is more than just sex,” says Andrew Lowden, Operational Wellbeing Lead at ellenor. “When you talk about sex and intimacy, most people immediately think about sexual intercourse. But being intimate can also be holding hands or waking up in the morning and just lying in bed with someone. Just because you have a life limiting illness, it doesn’t mean that that part of your life gets shut off.”
Plenty of research has highlighted the numerous physical, emotional and social benefits of sex and intimacy. They can make us feel closer with partners, boost our self-esteem, improve sleep and, for some people, can even provide a temporary distraction from illness.
“There are some genuine scientific benefits to sexual release,” explains Andy. “It reduces stress, it reduces anxiety, it reduces depression. Sex and intimacy can be used as a wellbeing tool to look after ourselves.”
It’s important not to dismiss the ways that sex, relationships and intimacy can be affected by a life-limiting condition and the move towards hospice care. Symptoms like fatigue, breathlessness, pain, nausea and vomiting as well as mobility challenges can not only make sex and intimacy physically more difficult, but also make it challenging to get into the right headspace to want to be close with another person. Seeing your body change as a result of surgery or treatment and adjusting to a new environment or new health needs is stressful, and your confidence and desire for sex and intimacy may be affected as a result.
Relationships and friendships can also change after someone receives a diagnosis of a life limiting condition. Partners in particular may find themselves suddenly thrust into a new role as a carer, rather than being a romantic or sexual partner. Even things like one partner moving out of a shared bed because of their illness can impact a couple’s connection. It can be helpful to discuss the strains that a life-limiting illness may have on your relationships and speak to the people involved in your care about how to maintain intimacy.
“At ellenor what we're looking to do is say, ‘Carry on being John's wife. We will help you to look after the care aspect so that you can carry on doing the things with John that you've done as his wife,’” says Andy.
For hospices it can sometimes be difficult to know how to approach intimacy within their services which can also make patients unsure about whether it’s okay to ask about. Though staff and patients may be comfortable with other deeply personal aspects of care, many people still consider sex and intimacy taboo and uncomfortable subjects.
But if sex, relationships and intimacy are important to you and are affected by your condition or care, start a conversation about it, however works for you. You might choose to first discuss it with a partner and ask them to pass on the message to staff, or you might decide to chat to a staff member you feel particularly comfortable with. You might prefer to write a note, or even ask them to read this article!
Though someone can face a number of new challenges when facing a life limiting condition, it doesn’t mean they should have to give up on sex, relationships or intimacy if they don’t want to. Here are some things to consider: