'This is not a whorehouse!' Sexual activity in long-term care.

摘要

A society's moral heart can be judged by how well it provides for its weakest and most vulnerable citizens. In recent years significant strides have been made to improve the quality of institutionalized persons' lives. However, because we have not yet fully developed a moral vision of long-term care living, residents do not always receive the basic care that they should. Particularly ignored and inadequately addressed is the complex moral and social issue of residents' sexual lives.; Currently there is little support for sexual activity or sexual care in long-term care settings. Society's moral rules are designed for independent people living in their own homes. Professional governance bodies have created moral rules regulating short-term professional interactions and responsibilities but rarely have ones that pertain to long-term care settings. The aim of the present research is to contribute to the development of a moral vision of how long-term care institutions should manage sexual activity and sexual care.; A qualitative study was designed to identify the factors that negatively influence sexual activity and sexual care, and the supports that residents and staff respectively need in order to have sexual lives and provide sexual care. Using an exploratory design the investigator conducted in-depth interviews with twenty-four residents and staff and carried out twenty hours of participant observation with two community residents. Six negative influences on residents' sexual lives and nine negative influences on staff's provision of sexual care were identified.; The work also explores ethical and legal issues pertaining to the provision of sexual care. It is argued that residents have moral rights to sexual care which impose duties on institutions to provide that care. Legal barriers to providing such care are then considered, and found not to be insurmountable.; The above research and explorations led to three conclusions. First, unless sexual care is available residents cannot have sexual lives. Second, for sexual care to be available institutions must accept that it is their moral responsibility to provide it and ensure that staff are adequately supported. Third, institutions should develop a framework for the delivery of sexual care.