A culture of change: Taking a person-centered approach to understanding sexual expression among long-term care residents
Over the next two decades, the United States will experience a substantial increase in the number of people reaching age 65 and older. While older adults today have more options when planning retirement or choosing a care facility than in generations past, as a society, we must prepare for the healthcare and housing needs of this sizable population, and the challenges that accompany them. As the need for long-term care increases, long-term care facilities (LTCFs), which provide medical or non-medical assistance for people with chronic illness or disability, must adapt their physical and cultural environments to meet the needs of their resident population. In recent years there has been a movement toward increased quality of care in long-term care (LTC) settings, and a shift towards whole-person wellness. Sexuality is one key component of well-being and preserving residents' rights to sexual expression is indicative of a LTCF's progress towards cultural change. The current paper utilizes the non-traditional dissertation format to address topics related to sexual expression among LTC residents in three papers. In the first paper, the authors determine the suitability of the physical and cultural environments of LTC facilities and their impact on the scope of residents' sexual expressions, including barriers to sexual expression. Additionally, better understanding of cultural competency within LTCF is provided through assessment of adoption of cultural change as related to sexual expression among residents. The second paper explores the attitudes, barriers, knowledge, and practices of long-term care administrators regarding sexual expression in long-term care facilities. The third paper is a perspectives piece which examines existing legislation and institutional policies regarding sexual expression in LTC settings and provides feedback for effective training guidelines for LTC staff.