If you or your partner is receiving palliative care here are some suggestions and tips for making space for sex and sexuality.
If you’re thinking about it, talk about it. One or both of you may be thinking about sex but afraid to bring it up. You might think that asking for sex is a burden the other shouldn’t have to bare. You might think that it’s the last thing your partner wants to think about. Try to bring it up in a way that doesn’t make your partner feel pressure, but instead focuses on your feelings. After all, wanting to connect sexually is a very positive desire, and even if your partner doesn’t want it, most of us are happy to be reminded that we’re attractive and lusted after by our partners.
If you’re not thinking about it, try. Sex may be the last thing on your mind and the last thing you want to do, which is fine. What isn’t fine is if you’re ignoring your sexual needs so much that you’re not even letting yourself think about it. Without making it a big deal, take just a little time to think about sex. How you’ve felt about it in the past and how you feel about it now that you’re nearing the end of a sexual life and possibly the end of a sexual relationship. Is there anything about sex that you do want to share at this time? You don’t need to belabor the point or feel pressure to want sex, but since sex tends to be a taboo topic, it’s worth checking in at least once with yourself.
Starting the conversation. Talk about your sexual fears and your desires. It can be hard to put something out there that you feel could be interpreted as a regret or anger or pressure, but if both of you agree that it’s OK to say what you want even if you can’t get it, then both of you get to speak your minds and hearts without censoring yourself. If you don’t have a lot of information about sex and palliative care you probably have questions. Make a list together and see if there are any questions you can help each other answer. Share stories about sexual things you did together in the past that you liked, or embarrassing times that you wished you could forget. Sex isn’t just intercourse, think about sexuality as all the things you do to make each other and yourselves feel desired, loved, attractive, intimate, and connected.
Use fantasy. Dealing with end of life issues can root you in a particular kind of reality, one where you are aware of your mortality at all times. Any kind of fantasy or daydream can be a welcome relief from what’s happening in you and to you. It can be a way to pass the time or to distract you from pain or boredom. Allowing yourself to sexually fantasize can help with creative thinking about how to be sexual if you’re body isn’t working the way it used to.
Think creatively. Sex is more than intercourse, and regardless of your situation there will be a way for you to be sexual (alone and with a partner). Focus on what you want to feel, not what you expect it to be like or what you’ve seen in movies. Ask for help if you’re stuck.
Want to learn more? See UpToDate's topic "Sexuality in Palliative Care" for additional in-depth medical information.
Moynihan, Timothy J. “Sexuality in palliative care.” UpToDate. Accessed: September 2009.