Sexuality in Older Adults Receiving Palliative Care: A Fundamental Dimension through the End of Life

The sexuality of older adults at advanced stages of illness, or at the end of life, remains a taboo topic that is rarely addressed in the literature and in practice. As a result, the knowledge base informing the support needs of older adults at the final stages of life with regards to sexuality remains scant. The present study seeks to explore experiences of sexuality in older adults with serious illness or receiving palliative care, focusing specifically on the place of sexuality in their lives, the forms of sexuality expressed, and the challenges this population may face regarding their sexuality. The study is based on an interpretive qualitative design and relies on individual semi-structured interviews conducted with 10 older adults, between the ages of 69 and 86, who were receiving services from a palliative care program. The interpretive analysis of transcribed data generated two divergent themes that appeared to represent participants’ overall experiences with sexuality: “Sexuality excluded from life” and “Intimacy and sexuality integral to life”. While the analysis suggests that a distancing from sexuality can occur at advanced and terminal stages of incurable illness, it also suggests that sexuality does remain an important part of life for some older adults at advanced stages of a condition. The analysis further revealed a diversity of sexual expression which included, intimacy, genital sexual practices, and sexual thoughts and fantasies. The study contributes to the deconstruction of ageist and ableist biases by contesting the desexualization of older adults at the terminal stage of illness or at the end of life. The findings highlight the importance of acknowledging and addressing the sexuality of older adults in palliative care settings and in research.