A guide to relationships, sexuality, intimacy

Relationships, sexuality and intimacy can be very difficult subjects to talk about at the best of times, but when you are living with a life limiting illness, they can be even more difficult to address. However, relationships, that is how we are with the people we love and who love us are fundamental parts of life, intrinsic to living well and wellbeing, especially at the end of life.

Your feelings and thoughts about your body and the changes you are going through may be really difficult, tough and challenging, and your relationship with your body and with people close to you will almost certainly be going through changes as well. It may even feel like everything you know is being consumed by these changes, your illness and survival can feel overwhelming, and feelings can become quite intense at times.

Feet poking out from underneath the sheets

What is sexuality and intimacy?

Sexuality and intimacy are important at various stages of our life and intimate expression can be especially significant at the end of life when time together with our loved ones may be limited.

Sexuality is the way that people feel and express themselves sexually, it can be difficult to find a precise definition, especially within todays much more enlightened society. It can involve biological, psychological, physical, erotic, emotional, social and spiritual feelings and behaviours, and can be quite complex.

We generally talk about intimacy as feelings of being in a close, loving, personal relationship, a close affectionate bond, familiarity or friendship. Intimacy can also be more physical, including touching and kissing, holding hands and hugging, it can also mean, being emotionally close to someone else, as in the intimacy of an old friend.

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Rearview of a happy elderly couple lying in each other's arms

Sense of Self and Body Image

Receiving a palliative diagnoses may be the most difficult think that you have ever had to cope with, and it will affect so may different aspects of your life. It may feel like you might not be able to trust your body anymore, that it has let you down, that all that you understood about your body has gone, and therefore why would anyone want to touch it or want to love it? Receiving your diagnosis may cause strong emotions for both you and your loved ones and you may not feel like being close to someone if you are anxious, depressed or worried. You may have changes to how your body works or looks, you may feel tired or fragile.

Sex and intimacy, being close to people in a loving way, not necessarily a sexual way can help you to find meaning and purpose in life. Especially where the physical act of sex may not be able to happen or may have diminished in significance due to perhaps physical or emotional reasons.

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Talk about it

If you are able to share with your partner or loved one how you are both feeling and what you are experiencing, it can really help. There may be guilt, anger, loss, frustration, sadness and many other emotions that it may help by expressing. By sharing these thoughts and feelings it may help you to understand what your loved one wants and find ways that you are both fulfilled and feel closer to each other. Talking about the challenges of the situation and the changes you are both having to adapt to, can help to make your relationship deeper and more fulfilling in other ways.

Perhaps finding a regular time and comfortable space to talk, which could be at the end of the day, sharing what has happened during that day and opening up communication can be a great relief, sometimes you may find that both of you are feeling the same way, but hadn’t spoken for fear of upsetting the other person.

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Touch, connection at the end of life

Touch is a powerful way of expressing and communicating love, comfort and support, and if we are lucky enough that touch will be present and important throughout our lives.

Touch can enhance well-being in relationships, the physical contact in the form of hugs, squeezes, stroking and brushing your loved ones hair can all be wonderful ways of gently reaffirming close relationships. And remember giving yourself a hug can be really nurturing too. There is also nothing wrong in asking for a hug.

But for many of us, especially as we become elderly and particularly approaching death, there can be quite a decrease in the amount of physical and emotional contact we receive.

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When your loved one has died

Being intimate with someone else after the death of a partner might feel really strange and make you feel a bit self-conscious. It can also be reassuring, rewarding and cathartic to be close to another person and a real step forward in the grieving process. Only you will know when the ‘right time’ might be to start a new relationship. And it is ok to do this, you aren’t replacing the person who has died, they are irreplaceable, but that doesn’t mean that you cannot have a rewarding and fulfilling relationship with someone else one day. Give yourself permission.

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Relationships, sexuality, intimacy

What is sexuality and intimacy?

Sense of Self and Body Image

Talk about it

Touch, connection at the end of life

When your loved one has died