New Guidelines Help Long-Term Care Communities Support Residents’ Intimacy and Dignity
Practical framework offers staff clear guidance on consent, communication, and person-centered care.
Intimacy doesn’t disappear in long-term care, but clear guidance on how to support it often does. A new paper outlines a practical framework for how organizations can move from uncertainty and inconsistency to a structured, ethical approach that respects residents’ autonomy while protecting their safety. At the heart of the model is the creation of a dedicated Sexual Health Committee, a multidisciplinary team charged with developing policies, guiding staff, and helping communities navigate one of the most sensitive — and often avoided — aspects of care.
Entitled “Enhancing Sexual Well-Being in Long-Term Care: A Framework for Effective Guidelines,” and published in Annals of Long-Term Care, the framework begins by establishing a Sexual Health Committee that brings together professionals across disciplines to lead this work. The Sexual Health Committee’s mission is clear: to support healthy sexual expression for all residents, including those with cognitive impairment, within well-defined ethical and professional boundaries.
Those boundaries are explicit to ensure that resident rights are balanced with safety and professional standards.
The paper’s primary focus is on helping organizations build their own approach. The authors encourage organizations to adapt the Sexual Health Committee model and resulting guidelines to their specific population, culture, and resources.
It lays out a process other communities can follow, with three core pillars:
- Ground the work in values, laws, and ethics.
Before drafting policies, organizations are encouraged to define their cultural values and align them with state and local regulations, and the ethical codes of clinical and caregiving professions. This ensures that any guidelines are both compliant and consistent with the organization’s identity. - Develop clear, standardized policies and procedures.
The Sexual Health Committee then translates those principles into practical guidance — creating written policies that address real-world situations, reduce ambiguity, and support consistent decision-making across staff. - Educate, apply, and adapt.
Training is essential to making the framework work. Staff are taught how to apply the guidelines in practice, including how to assess consent and respond appropriately. The Sexual Health Committee also serves as an ongoing resource, helping teams navigate complex cases and refine policies over time.
“Intimacy and connection remain important parts of life, even in long-term care,” said Rachael F. Arielly, PsyD, a psychologist specializing in geropsychology at Hebrew Rehabilitation Center and a co-author of the paper. “This framework is designed to help organizations create thoughtful, consistent approaches that reflect their values, support residents, and give staff the guidance they need.”
For residents and families, these guidelines reflect a shift toward more person-centered care that recognizes sexual well-being as part of overall quality of life. By promoting healthy sexual expression and establishing clear, consistent guidelines, communities can better support residents’ rights while helping staff navigate complex situations in a way that is both respectful and appropriate.
In addition to Arielly, co-authors included Nathalie Huitema, PhD, a clinical sexologist and Certified Sexuality Educator, and Sarah J. Rogers, LICSW, a clinical social worker and certified sex therapist.
About Hebrew SeniorLife
Hebrew SeniorLife is a national leader working to create a world where aging is defined by possibility, not limitation. We care for more than 4,500 older adults each day across seven campuses throughout Greater Boston, and offer support for families in the aging journey. Our services include in-home care, outpatient therapies, an outpatient memory clinic, short- and long-term inpatient care, hospice, independent and assisted living, and affordable housing with services. We conduct influential research on aging at our Hinda and Arthur Marcus Institute for Aging Research, which has a grant portfolio of $87 million, and train future health care workers at the Lunder CareForce Institute. Hebrew SeniorLife is a Harvard Medical School affiliate. Follow us on our blog, Facebook, Instagram, and LinkedIn.
