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Global Health Economics and
Sustainability
The challenges of caring

sample, quantitative methodologies, and longitudinal Ethics approval and consent to participate
perspectives to enhance the comprehensiveness and
applicability of the findings. Not applicable.

5. Conclusion Consent for publication
Not applicable.
Addressing intimacy and sexuality in long-term care
for individuals with dementia is essential for improving Availability of data
the overall quality of life and emotional well-being of
residents. However, the current lack of comprehensive Not applicable.
institutional policies, training for staff, and standardized References
guidelines for assessing consent and capacity in dementia
care highlights the need for systemic changes. Nurses, Bauer, M., Fetherstonhaugh, D., Tarzia, L., Nay, R., & Beattie, E.
as frontline caregivers, play a pivotal role in supporting (2014). Supporting residents’ expression of sexuality:
intimacy and sexual expression, but they often face ethical The initial construction of a sexuality assessment tool for
dilemmas, professional challenges, and insufficient support residential aged care facilities. BMC Geriatrics, 14(1):82.
in navigating these sensitive issues. https://doi.org/10.1186/1471-2318-14-82/TABLES/1
To create a more supportive environment for residents, Benbow, S.M., & Beeston, D. (2012). Sexuality, aging, and
a global approach is required, encompassing ethical dementia. International Psychogeriatrics, 24(7):1026-1033.
frameworks, professional training, family involvement, https://doi.org/10.1017/S1041610212000257
and the development of clear organizational guidelines. Bertola, L., Suemoto, C.K., Aliberti, M.J.R., Gonçalves, N.G., De
Addressing these dimensions can help balance respect for Moraes Rebello Pinho, P.J., Castro-Costa, E., et al. (2023).
residents’ autonomy with the need to protect their well- Prevalence of dementia and cognitive impairment no
being. Furthermore, fostering an institutional culture that dementia in a large and diverse nationally representative
normalizes discussions around sexuality and intimacy is sample: The ELSI-Brazil study. Journals of Gerontology-Series
critical in enhancing care practices and ensuring residents’ A Biological Sciences and Medical Sciences, 78(6):1060-1068.
rights are upheld. https://doi.org/10.1093/GERONA/GLAD025

There is an urgent need for more research to explore Cao, Q., Tan, C.C., Xu, W., Hu, H., Cao, X.P., Dong, Q., et al.
residents’ perspectives, the prevalence and nature of (2020). The prevalence of dementia: A systematic review
sexual expressions in dementia care, and the development and meta-analysis. Journal of Alzheimer’s Disease : JAD,
of tailored interventions. Longitudinal and qualitative 73(3):1157-1166.
studies can provide valuable insights into the needs of https://doi.org/10.3233/JAD-191092
residents and help shape future policies and practices.
Ultimately, by supporting sexual expression and intimacy Cook, C., Henrickson, M., & Schouten, V. (2022). Palliative care,
intimacy, and sexual expression in the older adult residential
in dementia care, we not only improve the quality of life care context: “Living until you don’t”. International Journal
for residents but also uphold their dignity, autonomy, and of Environmental Research and Public Health, 19(20):13080.
emotional health.
https://doi.org/10.3390/ijerph192013080
Acknowledgments D’cruz, M., Andrade, C., & Rao, T.S.S. (2020). The expression of
None. intimacy and sexuality in persons with dementia. Journal of
Psychosexual Health, 2(3-4):215-223.
Funding https://doi.org/10.1177/2631831820972859
None. De Medeiros, K., & Rubinstein, R.L. (2018). Managing sexuality
in long-term care: A new focus for person-centered care.
Conflict of interest Journal of Aging and Social Policy, 30(5):485-503.
The authors declare that they have no competing interests. Ehrenfeld, M., Bronner, G., Tabak, N., Alpert, R., & Bergman, R.
(1999). Sexuality among institutionalized elderly patients
Author contributions with dementia. Nursing Ethics, 6(2):144-149.
Conceptualization: Liliana Sousa, Celso Silva https://doi.org/10.1177/096973309900600207
Writing – original draft: Liliana Sousa, Celso Silva Farina, N., Rajagopalan, J., Alladi, S., Ibnidris, A., Ferri, C.P.,
Writing – review & editing: Celso Silva, Mónica Lopo Tomaz Knapp, M., et al. (2024). Estimating the number of people

Volume 3 Issue 3 (2025) 115 https://doi.org/10.36922/ghes.5130