Hazel Heath

Sexual health and well-being in later life

This article defines sexual health and explores the changes people experience in later life

Sexuality and sexual intimacy in later life

Sexuality is as important in older age as it is throughout life, and its expression can be positive, empowering, joyful and life-affirming. The concept of sexuality has many dimensions including identity, need and desire, relationships and behaviour, all of which develop through ageing and life experiences. The evidence on all aspects of sexuality in later life tends to focus on biological dysfunction rather than fulfilment, well-being and quality of life, and does not acknowledge the enormous diversity of older people in terms of age, sexualities, ethnicity and culture. However, the evidence base is growing and, in broad terms, what older people want is becoming more clearly articulated. This article acknowledges the current evidence and, building on this, suggests ways in which nurses working in health and social care services can address some of the challenges, enhance their own understanding and skills, and work creatively with older individuals to offer services that help them to live, and end, their lives according to their individual identities, choices and deepest, most personal, priorities.

Book Review: The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier...

Health care professionals’ perspectives of advance care planning for people with...

This comprehensive synthesis of published literature from a team in Northern Ireland focused on the perspectives of healthcare professionals in relation to ACP for people with dementia living in long-term care settings. From the 14 papers discussed, the authors identified that people with dementia are often not recognised as having a terminal illness. Four key themes were identified: ■ Early integration and planning for palliative care in dementia is important. ■ Healthcare professionals’ perspectives on ACP are influenced by ethical and moral concerns including presumptions regarding capacity of the person with dementia towards ACP and the impact of the increased role of the family in the decision-making processes. ■ Challenges in communicating with people who have dementia and their families. ■ A need for improvement in healthcare professionals’ knowledge of the disease trajectory of dementia with emphasis on end of life care, and a greater understanding of the process of ACP itself. This would assist them in engaging in ACP discussions.

Safeguarding vulnerable older people in hospital

Safeguarding vulnerable older people is the responsibility of all healthcare professionals, but what this means in reality and how it can be achieved in practice is not always well understood. This article provides guidance on how government initiatives can be used by nurses to improve the care of older people. The article identifies criteria for determining when a concern should be raised as a safeguarding alert and when neglect may be occurring. A positive culture encompassing zero tolerance of poor care in the hospital setting is advocated.

Environments and older people with dementia

The environment can have a profound effect on the quality of life for older people. This article describes how living and care environments can be improved for older people with cognitive impairment. Adapting the environment for the benefit of older people is now recognised as an important aspect of holistic care and even small improvements can make a big difference.