Can an intimate partner of a person with a disability provide assistance for eminently un-sexy tasks such as dressing, transferring, or bowel and bladder management—and still keep the romantic connection going between you?

Many couples would say, “No! Avoid this situation at all costs.” They would say that nothing takes the steam out of a relationship better than inserting a suppository. “Hire someone,” they urge. “Seek out all possible personal assistance (PA) programs—anything at all to prevent this innately contradictory mixture of roles.”

Then there are couples who will tell you that no one better than an intimate partner is going to make quite so complete a commitment to meeting the assistance needs of a partner with a disability. Plus it saves the hassle of having to manage and pay other people, who can be unreliable and sometimes more trouble than they’re worth. Some couples view the assistance relationship as a loving interaction that has deepened their connection and fostered greater mutual appreciation.

Some couples simply have no choice. The money or PA programs simply aren’t on hand. They have to make the most of it. So what to do? How do you keep the romance from being compromised by the assistance mode? How do you achieve the positive qualities that some couples report?

Start by looking at how the romance is doing in its own right. Relationships are complex by their nature. Ups and downs of sexy energy are the norm; if it’s not happening, it doesn’t necessarily mean it’s because of the assistance relationship. Take care not to make a scapegoat of the disability issue. It can be too easy to blame it any time the romantic energy isn’t there.

The more you foster the strength of the relationship itself, the less negative impact the assistance mode is going to have. Do nice things for each other, make a point to compliment and show appreciation for each other, and do the romantic things that work in your particular relationship—whether it’s serving breakfast in bed or springing for football tickets. Intimacy needs nurturing and feeding no matter what. With the added factor of the assistance mode, those needs should be made especially high priorities.

That said, the less assisting you have to be involved in together, then the less potential impact it will have on your intimacy. For that reason, you should make the fullest effort possible to optimize the independence of the partner with the disability. Maybe there is some cool product you didn’t know about in the occupational therapist’s catalog (i.e., for putting on socks). Or maybe there is a new tactile glove that helps someone with limited grip do more on his or her own. Take this to the limit, and you’ll get an extra fringe benefit: the partner with the disability will gain greater self-esteem from the increased independence and then will feel stronger in his or her role as an intimate partner.

That’s not to say that the reverse is true. Reliance on another person for help with personal needs doesn’t mean the partner with the disability must surrender self-confidence. Having a disability—and living a life in general—is a lifelong quest for gaining an ever-stronger sense of self. Receiving assistance from our intimate partner is just another way to gain that ever-greater grip on our innate right to feel good about ourselves, to know that we deserve love, and loving. It’s an opportunity to discover that the context of disability needn’t dial our self-esteem down a notch, nor our capacity for sensuality and love.

Be in agreement about how assistance tasks happen. Each person has needs in the process, and thoughts about the most efficient and safest way for it to go. Mistakes inevitably happen, so be willing to take responsibility and apologize if either one of you screws up or reacts impatiently on reflex. There won’t be any good lovin’ happening if you’re angry with each other because some conflict arose during the assistance task.

Timing, as they say, is everything. Don’t leave the more clinical assistance tasks until right before the time that you plan to be intimate. If the catheterization process is an hour or so behind you, then that gives you more freedom to create a new setting, a new quality in your time together. Once the candles are lit, the incense is burning, and Barry White is playing on the stereo, then it’s all about loving. Urine is old news by then.

Any break you can get from having to share the assistance tasks will protect you from the potential of having it overwhelm your intimate relationship. Respite is a real need for both of you. Recruit anyone you can—whether another family member or a trusted friend—to be trained in how to perform select tasks. Schedule an appointment with a therapist to do the training if necessary. Then call on your occasional assistants to provide respite. Be sure to give them lots of appreciation in return, or you can return the favor by babysitting their kids so they can go out on a hot date.

Another respite strategy is to start a savings fund to hire someone in from time to time. Throw a dollar or two into a jar every day, or whatever you can afford. Skip the expensive espresso drink and put the money in the jar instead. Just make sure to do it every day, even if it’s your pocket change, and pretty soon you’ll have enough for a few days worth of outside assistance.

Or save up for some special relationship treat. A romantic dinner, a bouquet of flowers, or a night at a bed and breakfast is an important event within any intimate relationship. Spend some fun and sweet time together, and the assistance task for the evening will take on an entirely new quality. You deserve hot dates, too.

In summary, there are plenty of ways you can manage the assistance role to minimize its impact on your intimacy as a couple:

  • Optimize independence for the person with the disability by fully exploring what s/he can do without assistance.
  • Time the assistance tasks so they don’t occur immediately before your opportunity to be intimate.
  • Coordinate the details of the tasks with each other to minimize conflict that could drain your loving feelings in the moment.
  • Provide respite for the partner without the disability by involving family or friends who can be trained in the performance of certain tasks.
  • Save money a little at a time—but steadily—for paid outside assistance and for a romantic date or gift that refreshes your intimate connection.


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Some caregivers can experience harmful side effects of overextending themselves, including depression.  Learn more about this common occurrence and how to handle it, in Caregiving and Depression a Common Combination.

For more information about caregiving, see Caregiver Basics and Resources: What You Need to Know.