There is evidence that the right of people with dementia to sexual expression is limited. While acceptance of consensual sex between older heterosexual adults and their former, or new, partners may be growing in residential care, this is not true of every care setting. Given the current emphasis on the individual, on the care home as ‘home’, and life there as a real continuation of the person’s previous life, this shouldn’t come as a surprise. The idea that some of the many thousands of older people living in care homes might have an interest in sexual activity has only really come into the open in the past decade. Some of the complexities of choice are highlighted if we think about an issue that is controversial at the best of times. , being lesbian, gay, bisexual or trans embraces many different aspects of a person’s sense of self, irrespective of age. One of the biggest single barriers to good practice in care for older LGBT people is the notion that sexuality no ‘Doing care differently’, (Independent Age 2017) They prioritise close relationships with staff members, providing genuine choice and control and offering a wide range of opportunities for meaningful activity. Eden Alternative care homes are run on the basis of alleviating these three conditions. They believe that boredom, loneliness and helplessness are the three ‘plagues’ responsible for the bulk of suffering among older people. The Eden Alternative, a care home concept originating in the United States, has a philosophy based on a sort of deficit-model but with a refreshing twist. It’s still personal (Association of Directors of Adult Social Services, 2017) These remain as relevant as ever and vital tools to ensure a high-quality adult social care system. Personalisation encompasses a broad range of approaches in adult social care: self-directed support, co-production, self-management, empowering information and community capacity building. Many local authorities have worked hard in challenging financial circumstances to give people greater choice and control. A person should decide how any funding should be managed and how best to spend it to meet their needs and achieve their agreed outcomes.ĭiscussions about taking personalisation further are happening in a very difficult financial climate. Personalised approaches such as personalised commissioning and Personal Budgets involve enabling people to identify their own needs and make choices about how and when they are supported to live their lives. The traditional service-led approach has often meant that people have not been able to shape the support they want. Personalisation recognises people as individuals who have preferences and puts them at the centre of their own care and support.
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