The purpose of this study was to (a) examine how age and sex of long-term care (LTC) residents influence public attitudes toward sexuality in LTC and (b) understand how, in the absence of cognitive decline, residing in LTC influences the perception of sexuality as a basic human right. Attitudes were examined using a factorial vignette with a probability sample of 325 respondents from a southern state. Results indicate that attitudes were not statistically affected by a vignette character's age or sex; but respondent education level, parenthood status, and religious affiliation did have direct bearing on attitudes. The notion of sexuality as a basic human right for residents of LTC was ultimately challenged as 19% of respondents said that LTC residents should not be permitted to have sexual relations with their spouse in the facility.
PurposeWe examined public opinion of sexual expression and dementia to inform nursing home policy and practice.Design and MethodsA content analysis was conducted on public comments (N=1194) posted in response to a New York Times article about a highly publicized legal case involving a husband engaging in sexual acts with his wife who had dementia, living in a nursing home. Researchers utilized constant comparative analysis to code the comments; reliability analysis showed moderately strong agreement at the subcategory level. Data were also coded to indicate whether the commenter thought the couple should or should not have been allowed to be sexual.ResultsOne primary theme was identified: conditions necessary for someone to be sexual. Six categories were identified within this theme, with the public commentary considering factors such as marital relationships, intimacy needs and several sexual consent‐related issues as key conditions necessary to be sexual in a nursing home setting. Overall, the majority of commenters were in support of sexual expression for an individual with dementia in the described situation.DiscussionThis study revealed sexual expression among individuals with dementia is a contentious issue with strong public opinions about how this should be managed in a nursing home setting. These opinions should be considered as policy related to sexual expression in nursing homes is developed.
While the bulk of Cooperative Extension’s (Extension) historical work has been with rural populations, its future work should also address the needs of those living in urban areas. The opportunity to live a long and healthy life is paramount among those needs. Cooperative Extension’ National Framework for Health Equity and Well-Being (Framework) provides a roadmap by which Cooperative Extension can help ensure that all people have that opportunity. The central premise of the Framework is that future work of Extension must include but extend beyond the promotion of healthy behaviors to place-based approaches for improving conditions in which people live, learn, work, and play. Recommendations for doing so include advancing health equity as a systemwide value, integrating data science with community voice to surface health inequities, investing in health-focused work, initiating new partnerships, and utilizing community development principles to influence social determinants of health. This article sequentially introduces the reader to the five recommendations and highlights how each of those recommendations is already being put into practice in urban areas of the United States.
Respondents who felt that a couple should not engage in a sexual relationship commonly cited consent-related issues as their primary concern. Implications for policy development are discussed.
Gray for a Day is an interactive educational curriculum that centers on use of an empathic model to improve knowledge, skills, and attitudes related to sensory and functional aging, empathy toward older adults, and one's own health behaviors. The program has been disseminated by Extension educators with varied audiences and evaluated with 2,440 respondents. Participants reported positive changes in knowledge, skills, attitudes, and intended behaviors. Cooperative Extension and community-based partners are uniquely positioned to use the curriculum to provide sensory experiences that can improve understanding of and empathy toward older adults.
The North Central Region Aging Network (NCRAN) formed out of a need to strengthen the potential for meeting curricular and educational demands related to the topic of aging. By pooling resources, establishing interactive and consistent methods of idea sharing, working collectively to assess community needs, and launching professional development initiatives, network members are able to effectively and efficiently address constituent needs across state lines. Early success and sustainability of NCRAN can be largely attributed to four lessons learned: (a) visioning, (b) shared leadership, (c) connection, and (d) data-driven decision making. Other Extension professionals seeking to address constituent needs may find success in forming similar collaborative networks.
Theorists argue that emphasizing changes to the policies, systems, and environments in which individuals live has more economical and sustainable impact on human health than interventions targeted directly to individuals (Kegler et al., 2015). We believe, however, that the ecology of the family remains an essential context for influencing individual behavior and contend it crucial that family life educators acknowledge the impact of family-level health-improvement initiatives. As such, we propose a behavior-change model for the family context that reflects the impact of interconnected family rules (policy), family relationships (systems), and the home (environment) on individual behavior, and acknowledge the underlying philosophical values that influence decisions about development, well-being, and health (see Figure 1; Bates & Yelland, 2018). Although the four framework concepts are interrelated, each can be conceptualized and operationalized uniquely. Future research will delineate techniques for evaluating how changes to family rules, family relationships, and the home impact human health.
Gray for a Day educates participants on age-related sensory and functional challenges through simulations that reflect daily routines, simple tasks, and social activities. Participants are introduced to healthful living concepts and means for promoting optimal aging and challenged to adopt healthful and empathic practices that will improve sensory, functional, and emotional wellness. The curriculum has been successfully pilot tested with a wide variety of Extension audiences, including 4-H youths, students, those who work with older adults, and intergenerational groups. A rationale for the program and a description of the curriculum and its materials are provided.
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