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Intimacy and sexuality

Issues of intimacy and sexuality are about much more than intercourse. They concern fundamental need to communicate and receive love, to feel at ease with their bodies and physical closeness (Gallagher and Monroe 2006).

Although most professional cannot be expected to become specialist psychosexual counsellors, all have a responsibility to become comfortable with offering and responding to cues about sexuality, offering first line help and referring for specialist support (Stausmire 2004, in Gallagher and Monroe 2006).

Mockford and others 2006

Changes in intimacy between couples significantly relates to the current strain felt by carers rather than to levels of anxiety and depression. Loss of intimacy was found to be predicted by cognitive/behavioural and communication changes. Around 50% of one sample of carers have an improved relationship with their partner and, in some cases, an improvement in their sexual relationship. Problems arise because of physical changes of the body leading to inhibitions: fear of rejection, not satisfying partner, degree of physical weakness, in particular loss of muscle strength, and the degree of sexual activity/passivity. Tube feeding and ventilation may also contribute to the difficulties. The continuance of an active sex life is more commonplace in patients with non-invasive ventilation than those with tracheostomy ventilation.

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