Whereas the gerontologists and sexual health experts I have quoted above advise couples about their sexuality, the gerontologist Araki discusses the relationships between nursing care workers and nursing home residents. She gives advice to nursing care workers on how to embrace the sexual identities and needs of older persons. Araki (2004: 59-69, 2005: 480-86) is a prolific writer whose ideas about aging and sexuality appear in popular magazines, nursing care journals, and urology and sexology journals. Her goal, she says, is to educate various constituencies, and especially nursing care workers, about the positive aspects of the sexuality of older persons. She aims to support seniors in activating their sexuality which, she says, refers not only to sexual activity but also to feelings, emotions, thoughts, and gender identity. Araki maintains that people have sexuality until the end of life. Even if sexual activity becomes impossible, the elderly have needs for closeness, intimacy, and physical touch (2004: 481-82).

Araki salutes some of the developments in the realm of nursing care, such as the creation of shared rooms for women and men, and shared bathing facilities. (Note, however, that elder care has largely been organised around heterosexual needs and expectations, and regular facilities may be hostile to gay and lesbian older people.) Still, she identifies problems in the ways that nursing homes as institutions accommodate the sexual needs of older persons. Typically, care workers are not adequately trained to engage perceptively with the needs of older persons. As a result when an older person says to a care worker, ‘I want to sleep with you’, the worker may take this literally, think the older person is saying ‘I’d like to lie next to you and feel your body against mine’, and react by registering a complaint that the senior has sexually harassed the worker (2005: 481). Alternatively, the worker may laugh it off, brushing aside the request. Araki says, however, that both of these responses are problematic because they miss what the elders are actually asking for.

Araki observes that the sexual needs of older persons are in fact more emotional than physical. To her, their sexual overtures to sleep together with nurses reveal a desire for a meaningful connection with a care worker that they feel close to. She explains that a good response by a nursing care worker to such overtures is to firstly acknowledge the need of older persons for closeness and intimacy, and secondly to meet these needs through appropriate physical touch. Noting the tendency in nursing homes to avoid skin-to-skin contact (hada nofureai), she advocates more such contact; she states that physical touch is very healing, especially for nursing home residents who may experience loneliness and anxiety in later life. She encourages care workers in nursing homes to create opportunities for human touch, for example, by giving older persons foot rubs, engaging in conversation, and remaining by their bedsides until they fall asleep (Araki 2005: 482).