Tommy Dickinson

Old(er) care home residents and sexual/intimate citizenship

ABSTRACT Sexuality and intimacy in care homes for older people are overshadowed by concern with prolonging physical and/or psychological autonomy. When sexuality and intimacy have been addressed in scholarship, this can reflect a sexological focus concerned with how to continue sexual activity with reduced capacity. We review the (Anglophone) academic and practitioner literatures bearing on sexuality and intimacy in relation to older care home residents (though much of this applies to older people generally). We highlight how ageism (or ageist erotophobia), which defines older people as post-sexual, restricts opportunities for the expression of sexuality and intimacy. In doing so, we draw attention to more critical writing that recognises constraints on sexuality and intimacy and indicates solutions to some of the problems identified. We also highlight problems faced by lesbian, gay, bisexual and trans (LGB&T) residents who are doubly excluded from sexual/intimate citizenship because of ageism combined with the heterosexual assumption. Older LGB&T residents/individuals can feel obliged to deny or disguise their identity. We conclude by outlining an agenda for research based on more sociologically informed practitioner-led work.

The influence of prison climate on the mental health of adult prisoners: a literature review

ACCESSIBLE SUMMARY Little is known about how the prison environment may impact upon the mental health of adult prisoners. This paper highlights that prisoners perceive that the prison environment has a negative influence upon their mental health. However, a small number regarded prison as a place of respite, which afforded structure and an opportunity to access health services. There is a need for more research in this area specifically relating to the impact the prison climate may have upon those from black and minority ethic groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. ABSTRACT Little is known regarding how the prison environment may affect the mental health of adult prisoners. Consequently, there is a need to investigate how this setting may exacerbate mental distress among this community. This literature review explores how the prison climate influences the mental health of adult prisoners. A thematic synthesis approach was used to elicit data relating to the aspects of the prison climate, which influence the mental health of prisoners. Four primary themes emerged from the synthesis: social, emotional, organizational and physical aspects. Prisoners perceive the prison climate to have a negative influence upon their mental health. However, perceived positively, prison was regarded as a place of respite, which afforded structure and an opportunity to access health services. There is limited research available specifically exploring the potential impact of the prison climate upon those from black and ethnic minorities groups. Nurses must recognize the aspects of the prison environment that may impact upon the mental health of prisoners and demonstrate innovation and imagination in their application of interventions. Additionally nurses need to take an active role in influencing and structuring the political agenda, which governs the clinical setting.

The challenges and opportunities in researching intimacy and sexuality in care homes accommodating older people: a feasibility study.

Abstract Aim To explore the challenges of conducting research on sexuality and intimacy among older care home residents. Background Sexuality and intimacy are neglected in care policies and practices. Design Qualitative analytical study drawing on poststructuralist theorizing. Methods Semi‐structured interviews were conducted with residents and spouses (n = 6) and care staff (n = 16) in two care homes in Northwest England in 2014. The sample was obtained through a network of ‘research‐ready’ care homes. Thematic analysis was used to make sense of narratives with the aid of NVivo10. Results Participant responses highlight the workings of ageist erotophobic discourse that undergirds the assumption of residents (and old people generally) as postsexual. This materialized in reservations about the research ranging from opposition on moral grounds to doubts about its feasibility given the age‐group concerned. However, residents and care home staff can also draw on counter‐discourses that resist/challenge ageist erotophobic thinking, which materialized in methodological and ethical recommendations. Conclusion Participants generally agreed with the principle of the research and made recommendations that could counter/resist ageist erotophobic governance and guide researchers on sampling, style of questioning and communicating with (prospective) study participants on a sensitive subject.

Nurses and subordination: a historical study of mental nurses' perceptions on administering aversion therapy for 'sexual deviations'

Nurses and subordination: a historical study of mental nurses’ perceptions on administering aversion therapy for ‘sexual deviations’ This study aimed to examine the meanings that nurses attached to the ‘treatments’ administered to cure ‘sexual deviation’ (SD) in the UK, 1935–1974. In the UK, homosexuality was considered a classifiable mental illness that could be ‘cured’ until 1992. Nurses were involved in administering painful and distressing treatments. The study is based on oral history interviews with fifteen nurses who had administered treatments to cure individuals of their SD. The interviews were transcribed for historical interpretation. Some nurses believed that their role was to passively follow any orders they had been given. Other nurses limited their culpability concerning administering these treatments by adopting dehumanising and objectifying language and by focussing on administrative tasks, rather than the human beings in need of their care. Meanwhile, some nurses genuinely believed that they were acting beneficently by administering these distinctly unpleasant treatments. It is envisaged that this study might act to reiterate the need for nurses to ensure their interventions have a sound evidence base and that they constantly reflect on the moral and value base of their practice and the influence that science and societal norms can have on changing views of what is considered ‘acceptable practice’.

Nursing People in Prisons, Forensics and Correctional Facilities

This chapter explores and considers some of the key practice issues that psychiatric/mental health nurses face when working within secure, forensic environments/settings. Despite P/MH nursing having a long history of working with this population, the provision of care within secure environments is problematic owing to a range of historical and contemporary issues. Accordingly, this chapter focuses on a number of key practice issues including the therapeutic alliance, prevention and management of violence and aggression, and the management of and therapeutic responses to self-harm. The authors point out that the secure environment can have a negative impact on the psychological health of patients contained within them, and that such patients are an exceptionally socially excluded group. Therefore, P/MH nurses must look to interventions beyond pharmacotherapy and become more recovery focussed to support patients to meet some of their basic needs. Additionally, they must draw on their skills, experience and intuition to identify those patients who are at greater risk of their mental health deteriorating as a result of one or more of these aspects. Finally, the nurses’ therapeutic alliance with people within prisons, forensics and correctional facilities is paramount. Therefore, P/MH nurses working with patients in secure settings should seek to re-evaluate their core nursing skills of therapeutic communication, of listening and being non-judgemental, and aim to demonstrate that they empathise with the challenging situation that their patients are in.

Openness, inclusion and transparency in the practice of public involvement in research: A reflective exercise to develop best practice recommendations

Reflective accounts of public involvement in research (PI) are important for helping researchers plan and deliver more effective PI activities. In particular, there is a need to address power differentials between team members that can prohibit effective and meaningful involvement.

Lessons from history offer insight into today’s professional practices: A new group aims to promote awareness of nursing’s past. Sally Gillen reports

Going on a date with a patient could easily lead to a fitness to practise referral - but until the 1970s it was almost part of the job for psychiatric nurses.