Couples living in twilight: A Heideggerian hermeneutic study of sexuality and intimacy in lifelimiting illness

The purpose of this study has been to understand the experiences of people living with a life-limiting illness in relation to sexuality and intimacy. Although the healthcare literature advocates that sexuality is addressed as part of holistic care, there is insufficient research evidence to guide healthcare professionals caring for people with life-limiting illnesses. It is unclear whether the current empirical evidence relating to the experiences and sexuality concerns of patients who are diagnosed with a life-threatening illness can be extrapolated to those nearing the end of life. Although the End of Life Strategy (Department of Health 2008) advocated identifying individuals’ wishes and preferences regarding their care, it is still unclear whether it is appropriate for healthcare professionals to broach the topic of intimacy and sexuality with terminally ill patients and their partners. In this Heideggerian hermeneutic phenomenological study, I have explored the meaning of sexuality and intimacy for patients and partners of patients who have life-limiting illnesses. I held conversational interviews with 27 patients and 14 partners of patients who had either terminal cancer or motor neurone disease. Consistent with Heidegger’s (1962) hermeneutic circle of interpretation, I used an adaptation of Diekelmann’s (1992) iterative approach to analyse the data. This study brings new understanding of the human condition. When someone is diagnosed with a life-limiting illness, it is not only their life that is limited, but the life of the couple is also dying. In their ‘being-towards-death-of-the-couple’, the participant who was dying and their partner experienced ‘connecting’, ‘disconnecting’ and, sometimes, ‘re-connecting’. The meaning that intimacy and sexual expression held for individuals was threatened by a range of factors including bodily changes, the physical barriers imposed by ‘enabling’ equipment, and death itself. Some participants were able to find alternative ways of connecting with their partner, while others mourned the loss of their coupled relationship and the potential for repair. These aspects of people’s lives were rarely broached by healthcare professionals. Although participants were unclear what role healthcare professionals might have, many reflected upon the value of being able to talk about their experiences. In concluding this thesis, I have provided suggestions for education, research and healthcare practice.

Grantor dc:publisher

Oxford Brookes University

Year dc:date

2012

Author dc:creator

• Taylor, B

Statement dc:rights

• All rights reserved

Language dc:language

en

Repository record dc:identifier

https://radar.brookes.ac.uk/radar/items/862e3752-0cd2-a088-3a90-880de1b7a46c/1/

OAI identifier oai:identifier

tle:862e3752-0cd2-a088-3a90-880de1b7a46c:d6bd9758-527a-46cd-bfe2-c433766e8fca:1