For all the innuendos and images surrounding sex in our society, it’s a topic that many long-term caregivers are reluctant to bring up with residents and their family members.

Sexuality is far more than being about sex, or as Freud might have put it, sometimes a cigar isn’t just a cigar. As Gayle Doll explains in her new book, “Sexuality & Long-Term Care: Understanding and Supporting the Needs of Older Adults,” sexuality encompasses many aspects of a resident’s life. This includes the desire for companionship and intimacy, the need for privacy, and holding onto one’s identity.

“Unfortunately, the only time many long-term care facilities address sexuality is when there is a ‘problem,’” writes Peggy Brick, the president of the Sexuality and Aging Consortium at Widener University, in her introduction to Doll’s book.

That can mean anything from public inappropriate behaviors to an adult child flipping out upon finding a parent has a new girlfriend or boyfriend.

So what can long-term care staff do to mitigate problems yet help residents still enjoy all parts of their lives? That’s what is great about Doll’s book: Rather than an academic treatise, “Sexuality & Long-Term Care” is a workbook, with activities and questions designed to help managers lead staff in creating a positive environment. Those questions can be basic, such as, “Does your organization have policies, which include consequences, to deal with employee or client complaints of discrimination or harassment, and is there a follow-up process?”

Other activities and self-assessments will open up sticky psychological wickets for staff based on one’s personal values and background. How does a staff member handle a resident viewing pornography, same-sex residents holding hands, or a dementia patient falling in love? Doll doesn’t provide the answers, but she does provide a framework for respecting resident’s sexual needs while protecting him or her from harm.

If you’ve been down this road and have thoughts to share, please leave them in the comments below. To sweeten the deal, a commenter will be chosen at random to receive a copy of Doll’s book.