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Health & Rehabilitation

2009-07-01 11:56:00

Stroke and intimacy

Question: My dad suffered a stroke (CVA) and is now home with mom after going through the acute care phase, inpatient rehab, and then home with some home health care therapies. Dad and mom love each other so very much and always have. Can they resume their physical intimacy (sex)?

Answer: Thanks so much for this question, as it is often left unanswered — or not even asked, due to embarrassment. Touching, kissing, hugging, cuddling, smiling, talking and listening are all needs we have as human beings, and they are part of our sexual existence that includes the ultimate intimate act of intercourse. Patients who have suffered strokes or any other traumatic event that interrupts or disturbs their lives can be left with the very question you have asked. Leaving it unasked or unanswered can lead to increased anxiety and depression. Fear of having another stroke during sex, fear of body image that may have been affected by the stroke, fear of rejection as an intimacy partner and fear of performance can all lead to depression and anxiety. The depression and anxiety then can perpetuate the fears, and on and on the cycle continues. Psychosocial support and communication are important. Inpatient Rehab and home health staff should provide education and support opportunities, and there are specialists in this area: psychologists, counselors, physicians, disability analysts and others. By all means, talk about it and ask questions. Depression symptoms can include: •A loss of interest in sex/intimacy •Generalized feelings of inadequacy or worthlessness •Constant fatigue, sadness, negativity and irritability •Restlessness and insomnia •Changes in weight and appetite •Memory changes •Decreased interest in socializing or pursuing pleasurable activities •Suicidal thoughts and attempts Depression itself needs to be addressed with regard to intimacy and sexual relations for stroke patients. Always talk to your physician about challenges whether you are the patient or the caregiver, and always discuss medications with your physician. Your physician can help assure you that the correct medications have been prescribed. Some medications work differently from person to person and have side effects that are the challenge. Simply changing medications under physician supervision can have huge positive effects. There are appropriate medications for use, as well as psychosocial support, and even medical mechanical devices that can be prescribed and/or suggested by your physician and medical team, to improve or enhance your individualized intimacy. The sooner a couple is able to resume intimacy (within medical approval) after a stroke, the less likely that anxiety, depression or fear will create roadblocks. Partners should try not to monitor performance based on previous history (prior to the stroke). Be patient, slow and communicate. Being well-rested and allowing enough time for intimacy can reduce anxiety, and can help overcome slowed physical response time. Depending on the severity of the stroke, patients and their partner may need to modify their activity to accommodate body strength, and levels of paralysis, and even bowel and bladder function. A adequate education by therapists and planning ahead can help keep these from becoming a barrier to intimacy. If the stroke patient’s intimacy partner is also the primary caregiver, consideration for caregiver breaks are needed. Caregivers need their time and space, as we all do, and this allows for that mutual renewal time. Always remember not to create false expectations. Communicate, consult with your medical team and then have fun together intimately.