Guidelines for a Palliative Approach in Residential Aged Care

Advocacy for residents should be foremost during this process. Therefore, a great deal of
education and counselling of the aged care team, families and other residents may be required
to assist them in accepting the need for residents to express intimacy and sexuality [339,345,347]
(Level QE; Level EO; Level EO). Members of the aged care team invariably project their own
sense of personal morality in these situations and thus their spiritual and cultural standards may
be challenged [337] (Level QE). The complex issues of intimacy and sexuality should be included
in staff orientation programs and in ongoing education and training programs for the aged care
team [341] (Level QE). Members of the aged care team may also need to air their concerns about
close relationships among residents, and a process to facilitate this discussion should be available
as required. Residents and families are generally left out of training programs; families who have
concerns about these issues deserve an opportunity to discuss their feelings.
9.3 Confidentiality
Although most members of the aged care team are trained in the importance of confidentiality
throughout their various careers, issues of sexuality require an additional reminder of
confidentiality requirements [341] (Level QE). It is normal practice for a staff member to share
with their co-workers information about the resident’s care. Although this information-sharing
is valuable in promoting teamwork within a palliative approach, discretion is required when
it comes to sharing information with colleagues about a resident’s intimacy and sexuality
needs [341] (Level QE). Two key questions to ask before sharing such confidences are:
1) Do I need to document this?
2) Do I need to tell my colleagues this information?
This process should prevent any unnecessary disclosures, thereby maintaining the resident’s dignity.
Consideration of residents’ sexuality should be a routine component of care; however, in
practice it is often neglected [341] (Level QE). There may be an assumption that as the resident
is receiving a palliative approach their sexuality needs are not important. Although this may
be the case, the aged care team needs to be aware of any cues regarding needs for intimacy or
sexuality from residents and to facilitate support for these needs as appropriate.
140 Guidelines for a Palliative Approach in Residential Aged Care