I was recently visiting with my brother and we were reminiscing about some old high school friends. Having been transported back to that time in my life and now sitting down to write a blog about my sexuality and aging book gives me a bit of whiplash. Sexuality and long-term care is the last subject I would have thought I'd know a lot about at ANY point in my life. But, I've been examining it for a while now and it's starting to fit me like a much-worn glove. You know when you love something you talk faster and louder and more passionately about it when the subject comes up?—that's where I am with sexuality and long-term care.

I wrote my dissertation on how to use culture change to make nursing homes better places for people to live. I was motivated because all four of my grandparents died in one of these institutions and I had grown to hate them. Soon after writing the dissertation I was privileged to work at the Center on Aging at Kansas State University developing training materials for nursing homes that highlighted the importance of person-centered care. We wrote about staffing practices, dining, activities, environments, spirituality, diversity and more. We thought we had covered it all until one day a staff writer brought the diversity module to me and she had included LGBTs (lesbian, gay, bisexual, and trangender). My colleague's inclusion of this group made me realize that we hadn't addressed sexuality as a whole. We decided to delay release until we could address this important topic.

I was embarrassed that I had committed such a glaring act of stereotyping. I had assumed—as have SO many others—that sexuality (and I'm not thinking of the sex act but the myriad other ways that sexuality is expressed and intimacy is sought) was no longer an issue for the frail elders living in nursing homes. Wanting to know if this is true, we conducted a survey in Kansas and found that we had a lot to learn.

Over those four years, I learned a lot about sexuality and long-term care. I wanted to share this learning with others and this book is the result. I have learned that

·       no one loses their need to be found attractive and loveable.

·       staff members may feel uncomfortable with resident sexual needs but it takes VERY little education to ease those discomforts and to awaken staff members to seeing residents as whole persons rather than the tasks they create.

·       while it is relatively easy to allow residents who are cognitively intact to have meaningful intimate relationships, it is much more difficult to give the same freedoms when a person has dementia.

·       nursing homes need to protect themselves from unexpected lawsuits and spending time creating sexuality policies goes a long way toward reducing these threats.

Most of all I have learned that it is possible to create environments where people can still love, in all its forms.

Gayle Appel Doll is the author of Sexuality & Long-Term Care: Understanding and Supporting the Needs of Older Adults.