6. Support for you the carer > Intimacy and relationships

Intimacy and relationships

2) Physical issues

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  • Fatigue .Problem If either or both of you are tired you are less likely to want to be intimate. TRUE- Solution Take time to let the person heal. They will gradually regain more energy and will be ready to resume relationships in time. If fatigue continues to be a problem see your doctor. If you are experiencing fatigue try to get help for some of the more tiring physical aspects of caring. Small changes or extra help could make a difference to your energy levels.
  • Pain. Problem Pain makes you less likely to want to be intimate. TRUE Solution Your doctor can help with managing pain in daily life. There are many options to try not just medication. This could apply to the person after stroke or you the carer.
  • Restricted movements. Problem Your partners arm and leg movements are limited so they will not be able to have sex safely again. FALSE Solution Consider alternative positions which could be more comfortable for your partner
  • Reduced sensation. Problem After stroke, if the person can’t feel one side of the body you must avoid touching that side. FALSE Solution If one side or part of the body has limited sensation it may be more difficult to become aroused but your partner will be able to say if they enjoy being touched on their affected side or not. Some people will enjoy being touched , others after stroke have unpleasant sensations such as heat, cold, tingling or even pain in the affected side.
  • Effects of medication. Problem Some medication affects getting or maintaining an erection. TRUE Solution Some medications for lowering blood pressure or antidepressants can have this side effect. See a doctor as some changes to type of tablets can resolve impotence caused by medications Using medication yourself which has not been prescribed such as Viagra is not recommended.
  • Other illnesses. Problem The stroke is causing all my sexual problems. FALSE Solution Diabetes and prostate illness as well as stroke can affect sexual function.If the person has these illnesses as well as a stroke they need to be treated too.
  • Hygiene.Problem You have to shower every day to be able to resume sex. FALSE Solution If it is difficult for the person to clean or bathe ask for an assessment from an Occup[ational Therapist for practical tips or bath equipment to help. If the person doesn't feel clean they may feel less attractive.
  • Reduced secretions. Problem Vaginal dryness after stroke can be overcome. TRUE Solution This can be resolved using lubricants.
  • Catheters.Problem I can’t have sex because of my catheter FALSE Solution Catheters are not difficult to overcome. Many people resume sex successfully with a catheter without too much difficulty. Seek advice from your doctor or Stroke Nurse
  • Expectations Problem Your partner has to be ready to resume intimacy. TRUE Solution You both need to be ready in your own time. Remember intimacy does not have to equal intercourse Touching, cuddling and kissing without expectation of full intercourse can be very reassuring. Give the person time to feel comfortable and close again. Let them know you are happy to be close to them.
  • Communication problems. Problem The person cannot express what they want so I will not be able to know in future what they feel. FALSE Solution Love and affection can be expressed by using body language alone if the person has communication problems. Touch, eye contact and facial expressions are all important clues.

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  • Fatigue .Problem If either or both of you are tired you are less likely to want to be intimate. TRUE– Solution Take time to let the person heal. They will gradually regain more energy and will be ready to resume relationships in time. If fatigue continues to be a problem see your doctor. If you are experiencing fatigue try to get help for some of the more tiring physical aspects of caring. Small changes or extra help could make a difference to your energy levels.
  • Pain. Problem Pain makes you less likely to want to be intimate. TRUE Solution Your doctor can help with managing pain in daily life. There are many options to try not just medication. This could apply to the person after stroke or you the carer.
  • Restricted movements. Problem Your partners arm and leg movements are limited so they will not be able to have sex safely again. FALSE Solution Consider alternative positions which could be more comfortable for your partner
  • Reduced sensation. Problem After stroke, if the person can’t feel one side of the body you must avoid touching that side. FALSE Solution If one side or part of the body has limited sensation it may be more difficult to become aroused but your partner will be able to say if they enjoy being touched on their affected side or not. Some people will enjoy being touched , others after stroke have unpleasant sensations such as heat, cold, tingling or even pain in the affected side.
  • Effects of medication. Problem Some medication affects getting or maintaining an erection. TRUE Solution Some medications for lowering blood pressure or antidepressants can have this side effect. See a doctor as some changes to type of tablets can resolve impotence caused by medications Using medication yourself which has not been prescribed  such as Viagra is not recommended.
  • Other illnesses. Problem The stroke is causing all my sexual problems. FALSE Solution Diabetes and prostate illness as well as stroke can affect sexual function.If the person has these illnesses as well as a stroke they need to be treated too.
  • Hygiene.Problem You have to shower every day to be able to resume sex. FALSE Solution If it is difficult for the person to clean or bathe ask for an assessment from an Occup[ational Therapist for practical tips or bath equipment to help. If the person doesn’t feel clean they may feel less attractive.
  • Reduced secretions. Problem Vaginal dryness after stroke can be overcome. TRUE Solution This can be resolved using lubricants.
  • Catheters.Problem I can’t have sex because of my catheter FALSE Solution Catheters are not difficult  to overcome. Many people resume sex successfully with a catheter without too much difficulty. Seek advice from your doctor or Stroke Nurse
  • Expectations Problem Your partner has to be ready to resume intimacy. TRUE Solution You both need to be ready in your own time. Remember intimacy does not have to equal intercourse Touching, cuddling and kissing without expectation of full intercourse can be very reassuring. Give the person time to feel comfortable and close again. Let them know you are happy to be close to them.
  • Communication problems. Problem The person cannot express what they want so I will not be able to know  in future what they feel. FALSE Solution Love and affection can be expressed by using body language alone if the person has communication problems. Touch, eye contact and facial expressions are all important clues.