In our culture, when we discuss intimacy, many people think immediately of sexuality. While sex may be part of an intimate relationship, it in no way encompasses it. When we think of intimacy as only sex it makes it difficult to focus on the other really satisfying parts of human relationships. 

Development of truly intimate relationships is difficult during times of good health and general well being. When someone is chronically or terminally ill, and is being provided physical care, they can find it very difficult to ask to have their emotional needs met also. Caregivers are often overwhelmed and may have difficulties verbalizing their own emotional and physical needs. There may be feelings of guilt and shame attached to having any physical or emotional needs. 
The primary concern of caregivers remains how to keep their relationship with their loved one at a level that provides emotional intimacy. In counseling sessions we advise our clients to remember the three A’s: 

Acknowledgement

Good communication is the key to acknowledging your loved one. Remember, in order to communicate effectively you need to: accept your differences, listen to each other’s opinions, and not close the door on painful subjects—including the wants and desires of the caregiver. 

 If your loved one is terminally ill, they may want to discuss their feelings about death. We would encourage you, as the caregiver, to be prepared for the inevitable and invite discussion whenever possible. As the caregiver, acknowledge the person’s feelings—be supportive of their view of the situation. Be careful not to take the attitude that, “I know what is best” or, “Do what I say.” 

Attention 

Paying attention to someone involves a lot more than monitoring his or her physical well being.You can let a person know that you are paying attention by listening attentively, making good eye contact and, by being aware of “non-verbal” communication, including how the person holds their body, tension, and lack of eye contact. 

Affection 

Emotional intimacy can be maintained through the simplest of physical gestures. A kiss on the cheek or forehead, coupled with a warm smile, a back rub, brushing the patients hair or just saying “I love you.” 

In an intimate relationship, both parties have to maintain a balance between closeness and separateness. This allows people to maintain their individuality and a sense of intimacy. The caregiver and patient can sustain a quality of intimacy similar to what they had prior to the illness. Having a healthy respect for the situation “the other finds themselves in” is crucial to all relationships! 

As the caregiver, you have emotional needs that your loved one cannot always meet due to their illness. You need to recognize that having your own needs does not take away from the wonderful relationship you have had or may still have with your loved one. They are a sign of your own “humanness.” Caregivers need to maintain a network of outside support by keeping relationships with family members and friends who can provide the acknowledgement, attention and affection that is still needed and well deserved. Taking care of these emotional needs will allow you to be focused on your loved one with a relaxed, positive, loving attitude.

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