Older Adults\u27 Intimacy Process in the Realm of Long-term Care

Research confirms the importance of social relationships to mental and physical health across the lifespan. Intimacy, a component of social relationships, continues to be essential in later life, including for older adults in long-term care such as assisted living (AL). Existing research provides insight into older adults\u27 social relationships, sexual behavior, and potential lack of intimacy. No previous study has conceptualized how individuals experience intimacy holistically and within the context of later life, health decline, and long-term care. The purpose of this dissertation was to provide an in-depth understanding of intimacy in the lives of older adults residing in AL. I address three major aims: developing a theory of intimacy in older adults\u27 lives, examining the intimacy of care and intimate care encounters from older adults\u27 and direct care workers\u27 perspectives and identifying the role family members play in older adults\u27 intimacy process in AL. Using a life-course perspective, feminist gerontology, and a grounded theory approach, I analyzed data from the Convoys of Care (Kemp, PI: R01AG044368) longitudinal, qualitative research project. Data consisted of 2,224 hours of participant observation, and interviews with 28 assisted living residents (aged 58-96) and their formal and informal care partners (n=114) over two years from four diverse AL communities. Older adults experience intimacy as an internal and external process through four dimensions: emotional, intellectual, spiritual, and physical. Intimacy may be experienced with another individual or within a group and can be platonic or familiarly, romantic, or sexual. AL residents\u27 intimacy outlets and needs were dynamic, varied over time and were an ongoing process influenced by managing one\u27s needs while negotiating intimacy opportunities and constraints. Residents experienced intimacy through a variety of relationships, but most often with family members, co-residents, friends, and AL staff. Through the intimacy of care, residents experienced close relationships with staff who were integral to their physical as well as emotional care needs. Family members served as cultivating intimacy in resident\u27s lives, supporting and encouraging some relationships while discouraging others. My findings have implications for practice and provide a more comprehensive understanding of older adults\u27 lives