Intimate touch does not always involve a sexual act. Intimacy shows itself in many forms in our world, including basic touching, patting someone on the back, and even caring for their wounds. In medical care, there will come a time when your patient’s medical care requires touching of an intimate nature. This could mean being close with deep tissue massages, debriding wounds on the body, or handling the genitalia to help with cleaning wounds or bathing. While intimate touch is not a bad thing, it is something that should be discussed with your patient before you begin. Make communication the forefront of your patient wound care and you will find that you and your patient will be on the same team.
Wound care, or intimate healthcare, is a very large part of cancer treatment, recovery, and maintaining bacteria free wounds. After reconstructive surgeries, some biopsies and other illnesses, wounds are left in different places of the body that require special care. Wound care may be needed from anything from cuts, scrapes, skin punctures, or stitches. In some cases, the spouse or partner may be given all of the necessary directions and become the wound caregiver, but that is not always possible for everyone. For those who do not have someone in the home that can provide this care, in-home or hospital nursing staff will take care of your wounds until they heal.
Many people sign up for in-home wound care, which involves a company with traveling nurses to schedule dates and times to come by your house. These nurses travel with the things that they need, and regularly check-in with your doctors. Your doctor and office staff can help you set up in-home medical care, as offices often utilize certain companies or have top-rate picks for their patients.
Helping with another person’s wound care takes a great deal of effort, knowledge and skill. Many nurses attend specialized training sessions, maintain certain certifications, and constantly learn new skills with on-the-job training. And while a specialized education is not a requirement for dealing with someone’s wound care, it does come in handy. Wounds can happen anywhere on the body for a multitude of reasons. Pressure sores and bed sores are frequent in the elderly community and with those who do not often move from the positions they rest in. Surgical sores and reconstruction sores are common after cancer related surgeries or procedures done to remove infection from the body in various places.
Despite the type or location of the wound, the touching that must occur to clean, dress, bandage and care for the wound is considered intimate touch. This type of touch can be hard for people to deal with for many reasons. Intimate touch can give feelings of discomfort, anxiety, and fear for both the patient and the person providing the wound care.
Home Care Provider Question: What is the right approach for initiating this type of contact? I do not want my patient to feel awkward or not be honest about their needs.
The best approach is the open and honest approach, letting your patient know every move you are going to make before you make it. This is especially true in situations where the patient’s wound is in an intimate area of the body. This is why your doctor will want to advise your partner on your wound care, even if you plan to have nurses come in to your home to assist. This gives another layer of assistance as many people are more open about medical issues with their partners than nurses or doctors. That said, in some situations, the patients are also shy and withdrawn with their partners due to the changes their bodies have made.
In some reports of the elderly being cared for by in-home nursing staff, the patient did not report genital wounds or issues to their caregivers because they were embarrassed to think that their nurse would have to handle their penis to clean the wound or help to deal with the problem of an erection that will not go away. Embarrassment plays a huge role in healing because when people hide their issues and ailments in fear that they will be judged or ridiculed by others. Fear is another major part of medical care for people who are in direct contact with another. The fear of new issues, the fear of painful treatment, and the fear of our bodies malfunctioning in front of another able-bodied person are all enough to make the patient feel like ignoring the issue may be a better option. Except that way of thinking is truly never the better option and it is our job to ensure that our patients always feel heard, seen, and respected.
Many specialists now state to first thoroughly give your new patient a full-body exam, noting any and all wounds that will need care. Form a written plan as to what you think needs to happen at each visit, along with what their doctor and medical care team has advised. After your written plan is done, sit down with your patient in a relaxed setting and go over your notes and plan of action. Ask them if they are comfortable with each step of the plan and explain each step-in detail so they know what to expect. Do not skip out on any part that might be painful or cause discomfort; instead, speak of those parts even more. By educating your patient with every aspect of care, you are empowering them to know what is happening and take charge of their care- even when it is your hands that are doing the work.
Nurse Question: As a female nurse, I find that my male patients have a tough time accepting help with genitalia care. I would guess my male nurse friends have the same issues with females. What would you suggest trying to help ease the situation?
Again, open communication and honesty about every step you take to provide care to them. Many elderly patients are no longer sexually active and being forced to deal with body parts that have abandoned them can leave them with heavy feelings. In other cases, having a woman nurse handling their sensitive reproductive parts can cause the stirring of old feelings and lead to sudden, unexpected erections, which led to further feelings of embarrassment. The same could be said about female patients and male nurses providing their intimate wound care needs.
Home Care Nurse Question: In my practice, our office states that our nurses will provide intimate wound care, but only if a family member is present.
This is how many practices provide care as a protective measure for their staff and for their patients. Having another person present, whether it be another home health aide or family member of the patient, assures that there is another layer of protection against unwanted touch, or unplanned treatments. For the patient, having someone they are comfortable with present during these more private procedures can help to ease their mind and stress levels. For the medical workers, ensuring that their patients are comfortable, and they are protected with witnesses means that no misunderstandings or unwanted touches are happening.
In any medical field or profession dealing with wound care and intimate touch, remember to treat your patient how you would want to be treated. Those who are going through continued medical care for any reason appreciate the openness and communication about their issues and care plan.