Supporting safe and healthy sexual expression for people living with dementia in urban and rural long-term care settings

Sexual expression has many benefits for older adults, including improved quality of life and mental health. However, persons living with dementia in urban and rural long-term care homes face many barriers to safe and healthy sexual expression. We do not yet understand why these barriers persist and how they affect practice and policy. Addressing these gaps in knowledge is critical for the development of educational resources to improve support of safe and healthy sexual expression for persons living with dementia in these settings. Our goal is to understand current practices around support of sexual expression of persons living dementia in urban and rural long-term care homes, and to develop and evaluate a digital arts-informed toolkit. This is an integrated knowledge translation study that will consist of two-phases of qualitative research. Phase I is a study of two long-term care homes, one in urban Ontario and the other in rural Alberta. In this phase we will use demographic questionnaires, observations, interviews, and document analysis. Observations will be of interactions between providers, persons living with dementia, family members. Interviews will be conducted with persons living with dementia (10/site), family members of persons living with dementia (20/site); care providers (25/site); managers (5/site); and professional consultants (5/site). Phase II is the development and evaluation of a digital arts-informed toolkit. The evaluation will be done using focus group discussions with all family members, care providers, managers, and consultants from Phase I. This study will advance understanding of challenges to supporting sexual expression of persons living with dementia in urban and rural long-term care homes. It will also identify examples of promising practices in this area. Our toolkit will help individuals and organizations to support sexual expression for persons living with dementia in these settings.