In a groundbreaking move for the care sector, Exemplar Health Care has designed training for its team around sexuality, intimacy and friendships in care homes. NR Times learns more about the industry-leading initiative and the benefits it will deliver to residents
“We are all sexual beings – we all want to be loved and we all crave intimacy at times. And that shouldn’t be any different for people who live in care homes.”
Such a powerful statement typifies Exemplar Health Care’s bold attitude to tackling head-on what has long been widely considered a ‘taboo’ subject.
The issue of sex and sexuality in care homes is something that is rarely discussed, even within care home settings, but determined to make a difference to this and bring greater empowerment to their residents, Exemplar Health Care decided to lead the change.
Now, after many months in the planning, Exemplar Health Care is rolling out its specially-created training programme across its 3,000-strong team and 34 care homes, after commissioning Enhance the UK to consult on a project to drive culture change, which includes developing policy, designing training and producing resources for the company.
“It isn’t just about sexual relationships, it’s also about platonic relationships,” continues Julie Booth, head of quality at Exemplar Health Care.
“We all have friends and people that we like to be with and interact with, and we want to give the people who live with us the same opportunities.
“At Exemplar Health Care, life is all about choice. We want to encourage and support people to feel comfortable and confident expressing their sexuality and sexual needs as they wish, and in seeking and exploring relationships of all kinds, in a way that promotes their choice and dignity, and ensures their safety.”
The project traces its roots back to 2019, when Exemplar Health Care worked alongside Leeds University to research the topic.
“We were looking overall at our service user’s needs, and realised we weren’t addressing some things as much as we should, and thought there may well be some unmet needs,” says Julie.
“We mainly support young adults, and apart from the tick-box questions on the admission form, we found that we didn’t consistently ask them about some more personal aspects, such as sexuality, and how that might impact on their life.
“We didn’t feel we could complete such impartial research, so asked the University to look at this for us.”
The research study’s remit was to understand the extent to which people’s needs were being met around personal relationships, intimacy and sexual expression.
The results suggested that many people who live in care homes thought that they weren’t allowed personal relationships, and how much people want a friend who was there through choice rather than because it was their job.
The extent of low self-esteem as a result of disability was also laid bare, with one participant asking: ’Why would anyone want to be with me?’
“Some of the comments were really poignant and it was quite clear they felt they were missing out on some aspects of life,” says Julie.
“We wanted to do something about this. For too long, these subjects haven’t been talked about, but if they are then people aren’t equipped to have these conversations so they can get shut down quite quickly.
“We wanted to help give people the confidence to explore these topics and talk about their feelings and needs.”
Working alongside Enhance the UK, the project was also a first for the charity, who had never before designed training for use in care homes.
User-led Enhance the UK is committed to changing the way people view disability, and through its #UndressingDisability campaign, which aims to normalise sex and disability, they work with care home colleagues to give them the ‘know-how’ so that disabled people can exercise their right of sexual expression in a safe and legal way.
Enhance the UK reports: “Disability can have a profound impact on your sex life, on the way you do it, and also the amount you have it. There are so many barriers facing disabled people who want to have an active sex life; self-confidence, self-esteem, finding a partner and overcoming physical and emotional barriers.
“In fact, all those same barriers apply to anyone wanting an active sex life. The difference however for disabled people is that no one seems to want to talk about sex and disability.”
The Exemplar Health Care training, which is being implemented across the group in a ‘train the trainer’ approach, is mid-way through its roll-out and already feedback is proving positive.
“We’re proud to be offering this training. We know that some people find these conversations uncomfortable and difficult, which is why we have a team of clinical experts who are committed to supporting the programme and ensuring that we make real change for the people we support,” says Julie.
“The whole idea is to start conversations and change people’s thinking around friendships, sexuality and disability.
“We complete a feedback form at the end of each session, looking at what they had in mind at the start and did their opinions change. A lot of people admit they thought it would be about sex and nothing else, but there is so much more to this than sex.
“For some residents it will be about sex, for others it is feeling attractive, making friends and acquaintances.
“We’re already seeing that people are thinking a lot more about the subject. There is a lot of misinformation about the law for example, what people can do legally and what are the boundaries, so we’re helping with that awareness too, as well as the mindset.
“We hope to embed this culture across the whole operation, in our recruitment, induction and supervision process.”
As well as engagement with the 3,000 care staff, Exemplar Health Care is also helping to liaise with residents’ families on the topic.
“Some family members may not be open to these ideas, but we have a lot of resources available to them to better explain the training and why we’re doing it,” says Julie.
“Sometimes we have to bridge the gap between the resident and their family, as their wishes may be very different to what their family wants.
“The consultations we have with our residents are confidential and very personal to them, and what we put in their care plans is done in collaboration with that person. They may not want their family or anyone else to know certain things, they may not want intimate information being seen by agency nurses, so we are guided by them.
“Their privacy, and what privacy means to them, is so important. No matter how much we do, how much training we have, they are never going to have the same levels of privacy and dignity that they’d have at home. These are things we take for granted, but things they have lost.
“With our training, and the change we hope to make as a result of that, we are trying to encourage a well-rounded look at the topics of sex, sexuality, intimacy and friendship – we’re not just going to ignore it.”
About Exemplar Health Care
Exemplar Health Care is a leading provider of specialist nursing care for adults living with a range of complex and high acuity needs.
They have over 32 specialist nursing homes and OneCare services which provide person-centred care and rehabilitation that focuses on maximising independence, building everyday living skills and empowering people to live as fulfilled lives as possible.
They support people on their journey from being in hospital or living in a secure setting to community-based living, as well as offering longer term support for people living with degenerative or life-limiting illnesses.
Find your local Exemplar Health Care home and get in touch to discuss your complex care placement needs.
