Monday, February 27, 2012

Let's Talk About Sex

So while I typed the title, you know I was humming the song, 'Let's talk about sex, baby; Let's talk about you and me.......' :)

I've worked at a variety of places where people are at different stages of the medical process. Right after heart or knee surgery, days, weeks or months after a stroke, etc.  I feel like we cover a lot as Occupational Therapists: strength, coordination, dressing & bathing, vision, assistive technology, cognition, range of motion, adaptive equipment, ergonomics, hand therapy, play, handwriting, social skills, and the list goes on and on! One thing that we have education on but often stay quiet about is sex/sexuality.

I never completely avoided the topic, but I didn't eagerly bring it up either. If it came up, I would at least let them know that as an OT we can cover the topic and give them education if they are seeking it ::: appropriate positions after a joint replacement or stroke. If they wanted information, I'd give them a handout and go through it with them, but that was pretty much it.

At my current job it is encouraged to be brought up at evaluations or during the treatment process if it is appropriate/applicable. Usually it's on our IADL (Instrumental Activities of Daily Living) list of questions to go through: Transportation, Money management, sexual activity, household management, medication management, etc. It's a lot easier to bring it up if it's along side other topics. Some clients are more than grateful that the question is asked and I am sometimes surprised at their response, while other times people like to keep that information to themselves and don't feel it should be addressed in therapy.

Looking for information that we can give? I'd check your textbooks from school, conferences, or check the internet (just be careful as there may be some crazy results). What can OTs assist with? Sometimes it's discussing positioning and giving handouts, 'adaptive equipment' options and resources for purchasing, pictures or other options to assist with aphasia, and education of the disease/injury process and how it can affect sexuality. I've often had people discuss problems with Erectile Dysfunction after a surgery or injury, and then I'll refer them to their physician as well, as I obviously am not prescribing any meds.

Other times I've had clients that act sexually inappropriate in public either with words or actions. This could be grabbing themselves or others inappropriately (I've seen this more often with people with developmental disabilities in pubescent kids into adulthood) or saying sexual or offensive comments to others (I've seen this more often with brain injuries or long-term drug abuse...which is also injuring your brain). In those situations it's more about finding the root of those behaviors and then finding solutions to them. Maybe they need a journal to write those thoughts down instead of saying them, maybe they needs some time each day to themselves to act on those feelings in their alone time instead of doing them in public.

There are a lot of options, and I'm no pro, but I'm working on making it more common in my practice as an OT. If you're thinking about doing this too, I'd suggest going back to your books again, digging into some research, as well as asking other therapists around you. You'd be surprised at what great suggestions you may get! One of the therapists I work with actually made a binder with a ton of information she has collected from conferences, books, and other resources, and it's so nice to have a lot of things together in one spot to use as a great resource. Sometimes it feels that it's a taboo topic in our culture, but we have to do justice to it and not forget to address it. Let me know if you have any more information that has helped you in this area!

No comments: