Intimacy and caregiving

Dr Larisse Badenhorst shares valuable advice regarding intimacy when your partner is your caregiver.


Intimacy and sexuality forms an integral part of every person. We are all sexual beings, no matter what our age, social status or well-being. The media has portrayed a ‘perfect’ picture, an idea of what ‘sexy’ is, and anything less than that makes you somehow incapable of love. This is not true. If individuals and couples put in effort, their sex life can be very rewarding.

There are challenges and changes associated with certain diseases but it does not take away your sexuality or your need for intimacy. Also remember that professionals can assist medically with associated sexual dysfunction or pain. 

Balancing the roles of caregiver and partner

Roles do change when one of the partners suffer from a disease. It can make it difficult for the ‘caregiver’ to see their partner as sexy and capable of giving and receiving sexual pleasure. 

Caregiving changes roles, alters expectations, and brings difficult responsibilities. Balancing the roles of caregiver and partner is delicate and might be difficult to achieve. It is hard enough to deal with sexual problems at the best of times; when illness or disability is added to the equation it seems impossible.

The key is to not look back at the dreams you had, but live in the present and maximise what you have now. It is always best to get someone else to do the caregiving, but if this is not possible, then you must make sure that you clearly separate the roles. 

There is no manual for sex, therefore communication is crucial. You must let your partner know you still have the need to remain sexually active. Don’t let fear keep you from embracing your own sexuality. Remember that you can still wear beautiful underwear or perfume, talk about what you enjoy and what you don’t.

Practical advice and tips to maintain intimacy

  • Do other things to maintain intimacy, such as weekly date nights, kissing, and holding hands. 
  • Expand your definition of satisfaction and rethink desire. If you are going to wait for your body to develop physical desire, you might wait forever. If you give yourself permission to engage in sexual activity, it will lead to pleasure.
  • When your sex life is challenged by a disability or illness, it is extra important to plan sex (prepare the room, consider mobility, etc.). Planned sex is better than no sex at all. 
  • There is more to sex than just orgasms. Whether you orgasm or not, find creative ways to increase your experience of pleasure. Take time to create a romantic atmosphere. Take it slow and utilise all your senses to get aroused and keep you in the moment. You must aim at creating special experiences rather than just focusing on physical release.
  • Be open to explore other options, like using sensation enhancing gels, vibrators or suction devices. 
  • Discuss masturbation. It is better to deal with physical sexual needs than to become frustrated and resent your partner. 
  • Make sure that there are no unrealistic expectations. There will be stages where one is going to be sick and unable to have intercourse for a while. Communication and understanding of each other is extremely important. When your health does not allow it, you should not feel pressured to perform sexually. 

Shared responsibilities and activities 

Being physically independent is not a pre-requisite for sex. You can find ways to work around it physically. However, being able to work and being independent are important drivers of self-esteem. Thus, when an illness leaves someone unable to have both, both the patient and their caregiver suffer. 

Experts agree this is one of the most difficult aspects of caregiving. Therefore, shared responsibilities and activities with regards to the sexual act are essential for meaningful intimacy.

In a loving relationship, attraction has much more to do with emotional connection than physical appearance. Creating special experiences, having fun together and really connecting, and seeking professional help if you need to, all contribute to a good sex life.

Dr Larisse Badenhorst is a medical doctor. She joined the My Sexual Health team, in Bryanston, Gauteng, during May 2019 as general practitioner with a special interest in sexual health and HIV.

MEET THE EXPERT – Dr Larisse Badenhorst

Dr Larisse Badenhorst is a medical doctor. She joined the My Sexual Health team, in Bryanston, Gauteng, during May 2019 as general practitioner with a special interest in sexual health and HIV.


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