Spring class explores intimacy needs of adults with advanced dementia

America’s elderly population is growing at a fast clip: The United States Census Bureau estimates that one in five of the country’s residents will be age 65 or older by 2030, and that this population will soon outnumber children for the first time in history. This creates a great need for professionals prepared to care for older adults facing life-altering conditions such as dementia.

The University of Wisconsin–Madison is addressing this need with its Advanced Dementia Care Specialist Certificate. Uniting compassion with evidence, this flexible program gives professionals the knowledge they need to provide high-quality care to people in the mid-to-late stages of dementia. In addition to studying current research on brain health, palliative care, speech pathology, conflict resolution, and related topics, learners develop skills and they can apply in their day-to-day work with clients and their families.

This spring learners can study a variety of important issues clinicians face, from ethical dilemmas (Feb. 22) to complex relational challenges (June 6). There’s even a class on addressing the sexuality and intimacy needs of people with advanced dementia (March 15).

Supporting self-determination

Tracy Schroepfer, a professor in the UW–Madison School of Social Work and a nationally recognized expert on aging, teaches the sexuality course. She says this topic is especially important to study because there are many enduring myths about older adults’ need to feel and express intimacy.

“One myth is that elders with advanced dementia are unable to self-determine whether they want to be sexually active, which can result in elders being denied the opportunity for their sexual and intimacy needs to be met,” she explains. “In the class, explore ways these elders can exercise self-determination and current nursing-home facility policies that either support or do not support them doing so.”

The class will also discuss the roles family members may play in decisions about intimacy and how clinicians can address their concerns in an effective, respectful way.

Professionals can apply their new knowledge about these myths—as well as the realities of older adults’ intimacy needs, common barriers to the fulfillment of these needs, and strategies for addressing these barriers—right away.

“At work, they can advocate that staff and administrators receive education on this topic, review the policies—or lack of policies—prevent elders’ expression of their sexual and intimacy needs, and support elders’ self-determination and decision-making with regard to this expression,” Schroepfer says.

Learners also benefit from new knowledge about physical and psychological issues older adults often confront, especially adults in the later stages of dementia.

A new generation of elders

Schroepfer says evidence-based training on caring for older adults is important not only because this population is growing but because its members tend to have different expectations than elders from previous generations, especially when it comes to sexual expression.

“Baby boomers will soon make up 20% of the American population, they are living longer than the elders who came before them, and they are more likely to be divorced, she says. “This generation also brought about the sexual revolution in the 1960s, grew up with fewer sexual limits than earlier generations, and have access to technologies and pharmaceutical solutions that can help them address physical issues that might impact their sexual expression.”

In other words, approaches to care that worked in the past might not be a good fit for many elders of the near future.

Schroepfer adds that expressing sexual and intimacy needs helps older adults achieve better physical and psychological health. This enhances the quality of their lives, even if they’re experiencing significant challenges like dementia.

“I have a passion for working with elders and care deeply about ensuring that the lives they lead are ones of quality,” she says.

An inclusive learning environment

Schroepfer leads her class in a way that encourages students to express their thoughts and ask questions.

“I try to make the classroom a community where all of us are active contributors to the learning taking place,” she explains. “Students aren’t blank slates when they enter a classroom. They have personal and professional experiences that enhance the learning. I want to honor that experience and the knowledge that comes with it.”

Recognizing that students learn in different ways, she uses a mix of instructional modalities. These range from brief videos and practice demonstrations to group discussions.

Schroepfer also stresses the importance of connecting classroom-based learning to learning outside the classroom. Sharing her own professional experiences helps her illustrate how to build this bridge. She draws from three decades of working with older adults, including hospice social work, volunteering in nursing homes, and academic work involving elders diagnosed with dementia. This includes research on using behavioral interventions rather than medication to address challenging behaviors some adults with dementia exhibit.

“Living with dementia is challenging beyond words, and I feel strongly that practitioners and family members can make it a little less challenging,” she says. “I want students to walk away feeling that the knowledge and skills they gain in my class will be useful in their work.”

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