Sexual support of people with intellectual or physical disabilities, psychiatric patients and demented elderly people

Some time ago there was an extensive article in one of the Dutch newspapers about the sexual support of people with intellectual or physical disabilities, psychiatric patients and demented elderly people. Since the end of the 1970s, various organisations have existed in the Netherlands for this sexual service. I also noticed in this article that one of these organisations uses the word Snoezelen in its company name. I think that is very appropriate.

Sex, intimacy and care. This is still a sensitive topic that many people and care workers don’t like to talk about. But everyone has needs and the right to intimacy and sexuality. On the Pyramid of Maslow it is even one of the most important necessities of life. So someone with a physical or intellectual disability also has a need and right to do so. It turns out that providing intimacy and sex improves well-being and well-being.

In 1974, this form of “service” was carefully started in Nieuw Unicum, a centre for people with physical disabilities at the North Sea coast in the Netherlands. Residents of this centre were given the opportunity to have intimate contact with each other or received help with masturbation if they were unable to do so themselves due to their physical disability. At first this often happened without publicity being given, but soon this was accepted both within the care of physically and intellectually restricted people. In 1982, the SAR (Alternative Relationship Mediation Foundation) was the first organisation for sexual services to be established.

We know several organisations for sexual services and support in the Netherlands. The services offered can vary in providing information and training to learn how to deal with the sexual need, providing support products to applying for a sex therapist or sex worker.

One of these organizations is Snoezelzorg

Snoezelzorg is a foundation that links the care demand of a client – people with a physical and/or intellectual disability, the elderly and people with a psychiatric background – to a snoezel caregiver or sex caregiver. They offer the possibility to make use of reliable and safe care.

There are costs associated with pike and sex care. These costs are often many times lower than what you would have to pay for a prostitute. Snoezelzorg therefore also has an advisory role for clients who take frequent care to avoid getting into financial trouble. In addition, aftercare is also important. Contact is made through a consultant to check whether everything has gone according to plan and what may have to change in the future.

Monique Bijkerk is responsible for the organization Snoezelzorg, accompanying an introduction:


My name is Monique Bijkerk, 48 years old, married and we have a daughter of 20. All three of us work in the Care and Welfare sector.

I have enjoyed working as a family supporter, mentor for people with intellectual disabilities   for a large healthcare institution for 11 years now. I am also founder and consultant of the Snoezelzorg Foundation.

I provide information and training to teams about sexuality, workshops on how to discuss sexuality and in care-related education I teach students how to deal with the health care issue of sex care. And recently I can call myself a Sexual Healthcare Consultant.

About the Snoezelzorg Foundation

The Snoezelzorg Foundation is a care institution that mediates in the intimate care demand for people with a mental disability, a physical limitation, psychological limitation and elderly people(with demantia). They also have the right to intimacy and a good sexuality experience.

The foundation works with experienced care employees who answer intimate care needs. In addition to offering intimate care, they know the diversity of limitations so they can ensure that the client can enjoy carefree, can and may be himself in all its facets.


During an intake interview, we map out the intimate care question and, if necessary, draw up a care plan with the involved psychologist or doctor. That is when sex care is used as treatment. So it can be monitored whether sex care is the right thing to do and / or whether the care plan needs to be adjusted.

For good mediation it is important to know who the client is, what the disability is, what the sexuality experience is like, any extra support or care needed, what any risks for the client or sexcare assistent are due to the disability or any background with bad seks experience.

After a mediation there is always aftercare. This is done through a contact moment with the client / mentor to find out whether the care question has been answered as desired. There is also a contact moment with the caresex assistent to check whether the mediation has gone well.