The challenge we were trying to address was to remove the taboo that surrounds ageing sexuality, and to support conversations in this area for older adults and the relevant communities of practice. We know that discrimination of any kind can have a significant impact on well-being. Older adults can face discrimination when it comes to being viewed as a sexual being, which is exacerbated when age intersects with sexual identity, gender, and ethnicity and race. These intersecting inequalities can prevent healthy ageing and disempower people through excluding them from health care and services. We know from scientific research that older adults don't always get the help they need when it comes to sexuality including their intimate and sexual lives. As people get older they are more likely to experience a sexual issue as a result of a health condition, medication, and/or their own attitudes towards older age. Older adults don't always seek help due to reasons including embarrassment, privacy of the topic, and fear of the health professional’s reaction. Those who do seek help don't always receive it: sometimes the health professional responds with, for example, ‘what do you expect at your age’. To complicate matters, research shows that older adults want health professionals to ask them about sexual issues, whereas health professionals want older patients to raise it themselves. The Charter helps overcome this impasse by legitimising the topic of conversation and providing guidance for professionals to use.

Older people in general, Both older and younger people

Education, Health

Government, Older People's Association, Academia, Health Care, Social Care

Older people were part of the process at multiple or all stages

The Charter was designed in partnership with Age-friendly Sheffield (previously known as Age Better in Sheffield), which is a £6 million project funded by The National Lottery Community Fund to reduce isolation and loneliness for people aged over 50 in Sheffield. My collaboration with Age-friendly Sheffield began in 2019 when I designed and delivered a workshop on sexuality and ageing for staff working in aged-care services (the workshop was attended by >30 staff including GPs, nurses, voluntary sector, counselling), followed by a presentation on this topic at their annual conference (attended by 150 delegates including older adults, service providers, voluntary and paid aged-care staff from all 14 Age Better partner organisations across the UK). The level of interest in the topic was high: we were oversubscribed for the workshop and conference presentation. Consequently, I pitched the idea for the Charter to the core partners, sharing my vision for an age-friendly and sexual rights friendly city. It was successful and a member of staff from Age-friendly Sheffield was assigned to the project. This collaboration enabled connection with community groups who Age-friendly worked with (see below for details how these groups inputted into the development of the Charter) as well as the Age-friendly Sheffield Steering Group (hosted by Age UK Sheffield). We worked with the Steering Group over two sessions to explore the acceptability of the topic, the appropriateness of the language used, the types of images to use, and any gaps and omissions in content we should address.

The Charter was designed so that the community, organisations, and service providers could tailor it to their own needs to support the sexual rights of older adults. One impact is that it has given the public and professionals a language to talk about a topic that is hidden and taboo. Community groups are using the Charter for discussions (e.g. well-being cafes) and art-based activities (e.g. poetry evenings). The impact of engaging with the Charter in this way is that it empowers people to talk about the topic. We are currently running these activities through a well-being grant awarded to Heeley City Development Trust from the UK Government. Health professionals are learning about sexuality and healthy ageing through the training described above. The impact of the training is shown through nurse evaluations of the course which were positive, demonstrating clear evidence of improved knowledge and skills: 93.75% reported an increase in ‘knowledge about the types of sexual difficulties older adults can face’; 100% reported an increase in knowledge about the ‘causes of sexual difficulties in older adults’; 93.75% reported an increase in ‘skills at putting an older patient at ease discussing sexual issues’. The Charter has started a public conversation about sexuality through media stories and the exhibition ‘Over the Hill, Under the Covers?’ for Festival of the Mind 2022. The Festival was attended by >15,000 people and feedback about the exhibition indicated that attendees had learned something new: that sexual rights apply to older adults.

We have received a lot of support from individuals and service providers, yet one issue we came across was the reluctance of some people to engage with the subject. This was expected and is understandable: sexuality is a private topic. We overcame this by spreading the word about the Charter as far as possible, this ensured that more people heard about the Charter and had the opportunity to input into its development. Our contacts with local authorities and services (described above) proved invaluable as we were invited to present the Charter at numerous forums and staff meetings (which continues to this day, highlighting the popularity of the Charter). We started the project in 2019 just prior to the Covid-19 pandemic. Understandably, all our lives were turned upside down. Our partner organisation had to take a step-back and prioritise the support of older adults in the community with regard to safety, companionship, and health care. We put the project on hold and picked it back up when the time was right in 2021. Another challenge was the funding required to do the work. We were fortunate to receive a grant from the Economic and Social Research Council to help us carry out our community consultation. We also received financial support from Age-friendly Sheffield through allocating a member of their staff to work on the project and covering printing costs. The Healthy Ageing Lifespan Institute at the University of Sheffield supported the work through design costs and providing expert consultation.

1) To not underestimate the power of connections. We received a lot of support from people sharing details about the project and offering platforms for us to talk about the Charter. 2) The value of working with community organisations and groups to co-develop materials that will benefit older adults as service users and professionals/staff as service providers. One of the questions I was asked (more than once) while developing the Charter was ‘why do we need a Charter for older adults, won’t younger people with their less conservative views change the landscape?’ My response was always ‘why wait for that to happen? And lets’ not forget that many of our current generation of older adults were change makers themselves, let’s not do them a disservice by asking such questions’. 3) The power of lived experience and voice.

As with all advocacy work it is imperative to keep going and not let the views of people who do not share your passion stop your progression. Not everyone sees this topic as a legitimate one. Sexuality is sensitive and often not prioritised at a policy and practice level for young people, so older adults face multiple barriers. But through working in this field since 2002 I have seen the changes that can be made when advocates don’t give up. My life has been enriched by the relationships I have made while doing this work. Relationships with older adults and those whose work brings them into contact with older adults. Human rights exist only in dialogue with others. I am grateful for their time and support.