Feasibility and Acceptability of an Education and Training E-resource to Support the Sexuality, Intimacy and Relationship Needs of Older Care Home Residents

A Mixed Methods Study

Maria Horne; Jane Youell; Laura Brown; Christine Brown-Wilson; Tommy Dickinson; Paul Simpson


Age Ageing. 2022;51(10):afac221 

In This Article

Abstract and Introduction


Background: sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents.

Objective: to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs.

Methods: we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews.

Results: fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology.

Conclusions: the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.


Sexuality, intimacy and relationship (SIR) needs are important to overall health and wellbeing in later life.[1–3] Although SIR needs are expressed in residential care settings for older adults, these needs are often complex, nuanced and remain a neglected aspect of care.[4–6] Evidence suggests that care home staff experience general discomfort when discussing and supporting residents' SIR needs.[7,8] Despite existing resources related to meeting these needs of older adults, with and without dementia, in residential and nursing home,[8,9] care staff are often not aware of them or where to seek guidance.[10,11] Additionally, staff training in care homes is varied, inconsistent and fragmented.[12]

A review of healthcare professionals' knowledge and attitudes towards the sexuality of older people highlighted a lack of knowledge and confidence in the area.[13] A recent scoping review identified few education interventions and training resources to support staff in addressing and meeting their resident's SIR needs.[14] The education interventions identified showed potential in improving knowledge and/or changing attitudes, in the short-term, towards older people's SIR needs in residential care settings but none of the existing interventions were considered appropriate for UK residential care settings due to contextual and cultural differences. To address this knowledge gap, we developed an education and training e-resource, through a co-design approach, to support care staff in meeting their resident's SIR needs and improve quality of care in this area of need.

Aim and Objectives

We aimed to evaluate and assess the feasibility, acceptability and usability of an education and training e-resource to facilitate staff to support the SIR needs of older care home residents. Specific objectives were to: (i) implement the e-resource; (ii) gain staff feedback on feasibility, acceptability and usability of the e-resource and (iii) gather initial data on potential changes in knowledge and attitudes to inform a future, full-scale trial.