Sex and intimacy in palliative care

The practice of palliative care prides itself in facilitating complex and uncomfortable conversations around death and dying. One such conversation is sex and intimacy, which healthcare professionals (HCPs) accept as integral to each person's identity. Yet, it remains one of the most difficult subjects to broach with patients (Hjalmarsson and Lindroth, 2020), leading to an unfortunate neglect of one of the most important aspects of person-centred care. Palliative care guidelines are clear that sexuality should be addressed. However, there are differing views and ongoing debates as to whether this is relevant with serious illnesses and when it is most appropriate to enable sex and intimacy for patients/partners. One of the principles of palliative care is to encourage HCPs to ensure people live as actively as they can until they die (WHO, 2020)—this includes sex and intimacy. Indeed, where intercourse is no longer possible, intimacy should be afforded, making it part of the assessment plan. Joint conversation should be had with the patient and their partner to agree upon the best approach.