Everyone is different, every couple unique. The physical and emotional needs of every person and every couple dealing with a serious illness are also unique. You may find that you’re content putting your sexual desires on hold while your energy is spent fighting your illness or dealing with its symptoms. On the other hand, you might find that intimacy with your partner is just as important to your well-being as all the other aspects of your treatment combined.
It’s important to note that sexual intimacy is a broad term and can extend far beyond “intercourse.” It can be expressed as any form of physical touch, whether it includes the genital areas or not. Physical tenderness, caressing, massage, tickling, cuddling, even hand holding are all ways to express physical intimacy.
Barriers to Sexual Intimacy
Unfortunately, there are many barriers along the palliative care trajectory that can get in the way of intimacy with your partner. Barriers that the palliative care patient often face include:
- Fatigue
- Varying moods – anxiety, depression, grief, guilt
- Changes in self image or self esteem
- Physical symptoms – nausea, constipation, pain
”Do I think about sex? Of course I do! I’m still human! But sex isn’t something my husband would want to do with me anymore. Ever since I got this colostomy bag, anyway.”– T.B., a 64-year-old woman with end-stage colon cancer
Partners may run into barriers of their own. They may be worried that their loved one is too sick to have sex. They might have feelings of guilt for thinking about their own sexual desires while their partner is ill. They, too, may feel fatigued and moody. The extra demands a loved ones illness puts on their partner can be exhausting and sex may be at the bottom of their priority list. And, to be honest, a partner’s interest just might be affected by that colostomy bag or other changes in physical appearance.
“She keeps on worrying about that colostomy bag. I’m not worried about it. Besides, there are lots of things we can do to be together, I mean sexually, that won’t put me anywhere near it.”– J.B., spouse of the 64-year-old woman with end-stage colon cancer
Overcoming the Barriers to Sexual Intimacy
The key to overcoming barriers to your intimacy is communication. Set aside some time when the two of you can be alone. You might find this challenging. Many people with a serious illness find privacy a rarity. Well-meaning family and friends my visit frequently, and visits from healthcare professionals can occur almost daily. You may find it helpful to set limits, for example no visitors after 7:00 p.m.If you have children, ask one of you helpful friends or family members to take them for a couple of hours. Turn the ringer off on your home phone, turn off your cell phone, and put a “Do Not Disturb” sign on your front door. Then cross your fingers and hope for no distractions.
Once you’ve managed to get some privacy, let the conversation begin. Start by asking each other open-ended questions about each other’s physical needs, desires, and wishes. Talk openly about any concerns or fears. Have a pen and paper handy and write down any questions that come up that you want to ask your healthcare provider. Some examples of questions to ask each other include:
- What type of intimacy is most important to you?
- What kind of touch would feel the best for you?
- How can I best fulfill your physical needs?
- What concerns you the most about physical intimacy or sex?
Allow each other time to express your feelings, and try to be open-minded. It’s easy to take things personally when talking about sex, and it’s even easier to become highly emotional when you’re already stressed. If you find you need additional help, ask your healthcare provider for resources.
Communication with your partner is only the first step. Managing symptoms and side effects of your illness and/or treatment is essential to enhancing your sexual experience.
