As I am sure you are aware it is pride month and I was having an interesting conversation the other day about how we bring up topics such as sexual orientation, pronouns, gender identity and sexuality with the people we support. As I have mentioned in previous blogs the cases I work on in my team are predominantly older people and I think some people feel uncomfortable asking the people we support these types of questions.
As part of our work we update the system with equality monitoring information and one of the questions asked is about sexual orientation. I have seen people complete this part of the questionnaire without actually checking that the information they are inputting is correct. I believe that what happens on a lot of occasions are people get a history from the person who talks about their marriage and an assumption is made about their sexual orientation. Just because someone ends up married to someone of the opposite sex this does not necessarily mean that they are heterosexual but this is what people base it on.
The difficulty that can come with having conversations around this topic is that a lot of the people we support have lived through a time where being gay was either illegal or a mental illness. They may feel that they do not want to share that information due to repercussions that could happen to them. Especially for someone with Dementia who is potentially living in a time where that is the case in their memory. It may be that the family don't even know this information about them because they have not felt comfortable to tell them. This would mean that part of their identity is lost because they either cannot or will not share that with us.
We are creating a document to be completed to give a picture of someone at a glance in one place. We put pronouns down on this form and this sparked a discussion about whether we thought that some of the people we work with would understand what we were asking. We support a lot of people with Dementia so conversations may need to be kept fairly simple so that they can understand so is this something that should be included? Or do we base the way we refer to them on what family or friends tell us.
This lead the conversation to the topic of sexuality in terms of wanting to have sex or sexual contact with someone else. We work with people in care homes a lot of the time and I think the assumption that can happen is that when people reach a certain age they no longer have an interest in sex any more so do not offer any support around it.
Is this viewed this way because of our own beliefs and prejudices? I often say to people about certain decisions a person makes, if they were younger would this be an issue? Why should it be any different when it comes to sex or exploring their sexual orientation. We forgot that the urge doesn't necessarily just go away because you are older.
The difficulty that can arise in situations like this is that we educate younger people on the importance of using protection both to prevent pregnancy but also due to STD's. If we aren't having open conversations or supporting people how would we know that they may need condoms for example. They may think pregnancy is no longer a risk so we don't need to think about that but actually that could lead to STD's being spread.
You also have situations arise where someone with a Dementia diagnosis may no longer be able to consent to sex but the partner struggles to understand that it is no longer an option. That person may have been in that relationship for decades and always had a fairly active sex life now all of a sudden they are being told by external people they can no longer do so. This opens up the conversation about at what point are we impacting someone's human right to private and family life. We also have to protect the person who can no longer consent as it would be classed as sexual assault or rape.
We are in a place of privilege where people share a lot of their information, background and history with us and it is important that we treat that with the respect it deserves. We are there for that person regardless and we need to make sure that we are accurately detailing the information about them and not just assuming based on a small piece of information. We don't know what is going on for people and being supportive is the difference between them wanting to share or exclude us.
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