Sexuality in palliative care : discussing patient sexuality and intimacy in palliative care

Experiencing a life-limiting illness has the potential to radically transform every aspect of a person's life, including how they feel about themselves, their body, and their sense of self within intimate and sexual relationships. For many people with a life-limiting illness, intimate and sexual moments are a vital aspect of their life, providing a sense of connectedness and assisting the person to explore and find meaning to living, dying, and death (Kadwell, 2016). Entering the palliative phase of any disease frequently results in a reappraisal of life priorities and relationships. This can impact the manner in which a person connects at the deepest level with a significant other, at a time when chronic and debilitating illness may precipitate a longing for intimate touch and communication. Sexual expression through all of life, but particularly during end of life phases, provides a vital form of communication, reassurance, tenderness, and validation of self when grappling with the vulnerability of changing health and wellness (Lemieux et al., 2004; Shell, 2008). Yet evidence indicates that few health professionals view patients in their care as sexual beings and if they do, they struggle to know what"” and how"”to raise the topic of sexuality and intimacy within their clinical roles (Hordern and Street, 2007a, 2007b; Gianotten and Hordern, 2011; Ussher et al, 2013a). This chapter will: Define patient sexuality and intimacy in the context of palliative care; Explore the impact of treatment for cancer and chronic illnesses; Provide an introduction to opening communication and providing practical strategies to support the patient through intimate and sexual changes.