title: Management of sexual expression in long-term care: ombudsmen's perspectives.
abstract: OBJECTIVE
  This study investigates sexual expression management in long-term care settings based on cases requiring intervention from ombudsmen. Although the literature frequently mentions a lack of policies governing sexual expression in these settings, there is little information available on management of situations when they occur. This study addresses these missing elements through the perspective of resident advocates.
  
  
  METHODS
  31 in-depth interviews using a multiple case study approach were conducted with long-term care ombudsmen in 6 states. A thematic analysis was performed on the interview transcripts.
  
  
  RESULTS
  Ombudsmen intervened in cases based on dilemma or conflict due to risk, risk associated with dementing illness, limited knowledge, privacy, and values. The theoretical framework of the total institution was utilized to interpret the results.
  
  
  CONCLUSIONS
  The results underscored the importance of resident advocates to support residents' rights. This research also highlights the importance of workforce training and examination of the institutional impact on resident sexual expression. Formulation of standards of practice for ethically complex situations is also critically important.
authors.affiliation: *Address correspondence to Laci J. Cornelison, Center on Aging, Kansas State University, 103 Leasure Hall, Manhattan, KS 66506. E-mail: ljh8484@ksu.edu.
authors.forename: Laci J
authors.initials: LJ
authors.lastname: Cornelison
authors.forename: Gayle M
authors.initials: GM
authors.lastname: Doll
mesh_terms: D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D009735:Nursing Homes; D010344:Patient Advocacy; D028701:Patient Rights; D061214:Patient Safety; D018907:Privacy; D012742:Sex Offenses; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D014481:United States