Introduction

Sexuality and intimacy have largely been seen as a domain of the young and attractive in contemporary society (White, 2011). Assumptions persist that the over-65s should be, or are, sexually retired (Bauer et al, 2007). Ageing has traditionally been associated with decline, frailty, unattractiveness, disability and illness, and wrinkly and withered bodies (through a western cultural lens, at least), so it is easy to dispel any notion that older people would enjoy a full sexual life, and by dispelling it we fail to support and encourage it. When adding to this the sense of distaste, disgust and taboo that older age sex seems to elicit, it is easy to see why there is a dearth of research, policy and good (pro-sex) practice (Bouman et al, 2006). Increasingly, the benefits of a full sexual and intimate life are being recognised across the lifespan, although research seems to focus mostly on ageing and heterosexual sex (Sinković and Towler, 2019).

For those who are older and identify as LGBTI+, there is significantly less evidence of good practice, and greater invisibility, particularly around supporting sexuality and intimacy (McGovern, 2014; Sinković and Towler, 2019). To ignore the importance of sexuality, intimacy and relational needs does older people, especially those already marginalised, a great disservice. The physical, psychological, social and emotional benefits of intimate relationships arguably result in greater pleasure and liberation with age (Rowntree, 2014). Sex, intimacy and relational needs are fundamental to wellbeing, and with the advent of the recent Care Quality Commission (CQC) guidance, health and social care services will be required to show evidence of how they support relationships and sexuality within their services (CQC, 2019), including the LGBTI+ community. This chapter seeks to explore this much-neglected area and add to the scant literature by offering an argument for better LGBTI+ inclusive aged care provision, by reducing invisibility of older LGBTI+ people and by offering examples of good practice using an Australian case study which could be utilised in a UK context.

Context

This work comes about following my research into sexuality, intimacy and relationships affected by dementia (Youell, 2015). The findings of this research suggest that older people are poorly served in terms of their relational wellbeing.