THE SEXUAL NEEDS OF PEOPLE WITH DISABILITIES – EMOTIONAL NEEDS (CASE)
Tom Smith is in his 30s and is a professional man. He developed multiple sclerosis some years ago. The disease has been progressive and increasingly incapacitating. He has had to give up work as he is now unable to cope physically with the demands on him. The stress of the illness has put a strain on his marriage and he is now divorced. He is very distressed at the loss of his children.
He became unable to look after himself and went back to the parental home where his parents cared for him, indeed smothered him. He felt he was treated as a child. In addition to needing physical care like a child, such as washing and toileting, he felt put down and emasculated. He could not see how he could live out the remainder of his life like this.
He arrived to see the doctor in a wheelchair. The disease had resulted in total inability to walk and in some loss of hand function. In addition his speech was affected. This meant he had to take a deep breath and run his words out in little quick bursts which exhausted his energy, and he had to rest and start again. The doctor’s technique of asking an open-ended question and allowing the patient to talk at length was thus unusable. Comments had to be phrased in a more direct way so that he could make short replies. The doctor needed to try to pick up on his feelings so that he could either accept or reject any assumptions made. It was clear that he found this enabling and the doctor was conscious of the need to allow him to be a man, and be treated like one, with difficult issues addressed and not evaded or ignored.
He very much wanted to utilize the remainder of his life, hopefully with a sexual relationship, but was diffident about the response he would get as he was not ‘a good catch’. One day the doctor commented, ‘Only the outside of you is changed, the old you is still there inside.’ His smile lit up and he said, ‘Too right – on the button.’ This recognition was very important to him. His mind was crystal clear, only his body would not respond to his demands on it. His need for independence was discussed and he eventually found sheltered accommodation where he was again able to take responsibility for much of his own life. He has since met a partner and has a happy relationship.
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