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Those of us who've become, for one reason or another, reliant on someone for intimate care will know how humiliating it can be. Yet for some people with learning disabilities, intimate care is an experience they must endure every day. Julie Clark assesses the factors that should be considered to ensure this crucial part of care is carried out sensitively
Keywords
* ethics
* self care
* empowerment
These keywords are based on the subject headings from the British Nursing Index. This article has been subject to a double-blind review.
For people with learning disabilities, dependence on others for intimate care might be caused by deficits in cognition and difficulties with carrying out practical and adaptive skills. These difficulties can be compounded by the presence of sensory and physical disabilities that restrict movement and the ability to carry out fine and gross motor skills that are required for self-care.
Intimate care and personal care refer to a wide range of activities and these terms are often used interchangeably. Cambridge and Carnaby (2000a, 2000b) have defined intimate care as: 'The care tasks associated with bodily functions, body products and personal hygiene which demand direct or indirect contact with or exposure of the sexual parts of the body.'
Cambridge and Carnaby (2000a) have suggested that the term 'personal care' can be used to refer to tasks which do not involve contact, or exposure of, sexual parts of the body and are often associated with personal presentation such as brushing hair and shaving.
This article focuses on the provision of some of the tasks that were included in Cambridge and Carnaby's (2000a) definition of intimate care, namely:
* dressing and undressing
* helping someone to use the toilet
* changing continence pads
* bathing and showering
* washing intimate parts of the body
* changing sanitary towels and tampons.
The importance of intimate care
Intimate care can occupy a large amount of the day, and the way in which intimate care is carried out is therefore likely to contribute to quality of life. For example, bathing has been identified as a potential source of pleasure for many people (Rader 1994), but if an individual is given a bath that is too cold or only lasts for a...