Home' Australian Ageing Agenda : AAA Jul-Aug 2014 Contents Colm Cunningham Angela Raguz
WHY DO WE NEED TO DISCUSS
Our starting point in my view is to remember
first and foremost we are talking about human
beings! If we are genuinely talking about
holistic care and support and not just physical
care then we need to talk about the person and
every aspect of their lives. The area of sexuality
is no different to other aspects of care. The
problem is if we don't have the conversation,
we don't know! One of the other reasons we
need to talk about sexuality is it comes up as
an issue more often than people want to admit.
WHAT IS THE CONSEQUENCE
OF NOT DISCUSSING THESE
It ends up being a problem for the person
with dementia, the care service, their family
and friends. More specifically, if we don't
have these difficult discussions, it means
that if something happens we don't know
what to think and we simply hit the panic
button. We need to talk to the person and
their loved ones, where appropriate, to
discover as much as they are happy to share
about their need for intimacy, affection and
love. Is the person widowed? Do they have a
good relationship with their partner? Are we
supporting them to have the space and time
alone or with others that they may need?
WHAT IS A TYPICAL PROBLEM
IN THIS AREA?
Often with families members they feel that
they are obligated to make decisions because
the person has dementia. In general, parents
don't explore with their children what they
want in relationships. This makes it a grey
area. The aged care facility meets the person
when they have dementia as well as the
family in the context of this change. People
change and so do the choices they have --
for the facility they have a lot of information
to gather. The children of someone with
dementia may not have lived with their
parent for many years, so they too need to
take account of the person now.
WHAT SHOULD INFORM OUR
APPROACH TO SUPPORTING
THE PERSON WITH DEMENTIA?
Often the wrong starting point is to apply the
same moral code to someone with dementia
as to that of a teenager. Knowing the person
remains the starting point in everything
about supporting people who have dementia.
Understanding their emotional responses
and if they are happy in that moment and in
the intimacy they are sharing is also key.
The Emotional Responses in Care (ERIC)
tool developed by HammondCare can
provide a structure to the assessment. We
also have to be honest; at times it may be
hard to measure the gain, or indeed the loss.
So assessing the harm may well be the key
question. We cannot assume that a person's
capacity to choose and make decisions is
lost in all situations, just because they have
dementia. Their rights need to be central.
Supporting the family is important, but it has
to be done in a way that respects the rights
of the person with dementia.
I am not saying it's easy, but I am saying
risk aversion in aged care results in bad
outcomes for the person we are primarily
there to support. If risk aversion is as good as
it gets then we will have dissatisfied people.
All of us are a product of sex, yet we don't
talk about it. Name the risk and then we can
talk about how we manage it. n
Associate Professor Colm Cunningham is
director of the Dementia Centre. Angela
Raguz is HammondCare's general manager
for residential care.
leads to them valuing
compliant behaviours, and they
will speak up when they see
others being non-compliant
and letting the team down.
Any mandatory compliance
training should be led from
the front by management,
with active support from the
Together with any
mandatory training, at the
top of every manager's
priorities should be the
participation in awareness-
raising on compliance and
expected behaviours of
employees. If it is not, then
they shouldn't be surprised to
find non-compliance issues,
no matter how many training
programmes employees have
been compelled to attend.
In the end, it's all about the
culture, and leadership drives
Future activity and focus to
improve regulatory compliance
won't rely on training, it has
always been, and will always
be, primarily dependent on
leadership and management.
Good leadership uses good
education to drive good care
outcomes, and in the process,
compliance happens. n
Natalie Duggan is head of
A highlight of
Conference in late June
was a panel discussion on
sexuality and people with
dementia. Here Colm
Cunningham speaks to
panellist Angela Raguz.
Let's talk about sex
Australian Ageing Agenda's regular
dementia supplement is compiled
by Colm Cunningham, director of
HammondCare's Dementia Centre.
For further information, email
go to: www.dementiacentre.com.au
www.australianageingagenda.com.au | 55
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