As an OT, I am involved with many different people's intimate occupations. Before fieldwork, I hadn't counted on how often I would be immersed into the land of bodily liquids. I assumed that I could just call for nursing to assist with things that were outside my tolerance. Laughingly, I know that I now cannot count the number of bedpans applied, commode transfers, and assists with hygiene. There is a particular child I see who never ceases to slobber over both my arms and my shirt. My tolerance for such events has had to improve, or I wouldn't be able to help people with what they are struggling with. You can't want someone to practice cooking with you but turn them over to nursing when they have an accident and need help with hygiene. On a cleaner note, even the outpatient side of therapy can bring you to a point of TMI from a client. People tend to open up about things over an ultrasound machine, including things you didn't need/want to know. Several of my final days as a job shadower at the outpatient OT clinic had me distracting a young girl that needed whirlpool debridement of 2nd & 3rd degree burns. It was my job to chat with her so that the OT could do his job. She shared numerous things that I am sure her mother (in the room) did not want to be known outside of the family, including her father's suicide and how often mom's boyfriend stayed at the house.
Despite how deeply thrust we are into clients' personal lives, there is a topic that we often shy away from... despite it being a Basic ADL. That's right, it's sex. There's an unfortunate stereotype that many of our clients- the elderly, those with developmental delay, people with severe physical or mental disabilities- aren't sexual beings. I remember being somewhat shocked in high school when a classmate (12 years s/p TBI) made comments about wanting to make out with someone. The movie Murderball addressed this head-on in a way you could expect from MTV. But still, sex isn't something that we often address with clients unless they gather the courage to speak first and persist until they get information. There are handouts, books, and videos addressing sexual techniques for people with various injuries and disabilities. And now, there's a dedicated edition of Savage Love, with a coauthor from the book The Ultimate Guide to Sex and Disability. (Warning: this site is not safe for work and should probably be considered R-rated) While it's a very short article, just let it serve as a reminder that you can't assume anything about a client, they probably do have questions, and that there are important resources available. I especially enjoyed the emphasis that a depressed person with a disability has community resources and needs to get out of the house and into the world, but that's another story. The article also links to Independent Living USA, which is a site that has numerous links for pretty much anything disability-related.
So be warned, future OTs, the issue will surface. On my level 1 fieldwork, a young man in his 20's w/ a SCI wanted to know more about masturbation, dating, and general issues. And the OT did her job- she pointed him toward good resources, brainstormed possible adaptations, and made herself available if he had more questions. I sincerely hope that I would handle such a question with the same grace.