Sexual Expression of Nursing Home Residents: Systematic Review of the Literature.

PURPOSE: Living longer, baby boomers will need specialized care offered by nursing homes to manage chronic conditions. This review explores the knowledge, attitudes, and experiences towards older people's sexuality and sexual expression in nursing homes-an important area of research to meet the needs of this emerging population.

DESIGN: A primary search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases and secondary inclusion of cited references covering the period January 2000 to November 2016 identified 12 relevant studies.

METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of the screening process, data were extracted, summarized, and compared, and risk of bias was assessed focusing on ethical considerations, sample size and sampling methods, validity and reliability of data collection instruments, participation, cooperation, and response rate.

FINDINGS: Overall, sexual expression in older adults is recognized as a basic need that should be supported. Positive attitudes towards sexuality in nursing homes were correlated with a higher level of knowledge about older adults' sexuality. In addition, positive predictors of attitudes towards sexuality in nursing homes were found to be: age, level of education, and years of experience. Barriers to addressing sexuality in the elderly are the lack of privacy and staff discomfort, which together represent common causes for loneliness and lack of intimacy in nursing homes.

CONCLUSIONS: Nursing research and practice need to shift their focus towards individual needs of nursing home residents to accommodate their values and expectations.

CLINICAL RELEVANCE: Care providers must include a thorough assessment of sexual health of older adults living in nursing homes in routine practice, and include sexual health in the treatment plan.