HSCP-KALLIS scale offers a structured way to measure staff readiness on later-life intimacy
A new measurement tool aimed at a topic often left unmeasured has taken an early step toward clinical use. The HSCP-KALLIS scale was developed to assess health and social care professionals’ knowledge and attitudes toward later-life intimacy and sexuality, with added consideration for older adults living with dementia and people from diverse gender backgrounds.
The need for a structured instrument is easy to understand in clinical settings where intimacy, consent, dignity, and safety intersect. Older adults continue to have sexual and emotional lives, yet staff confidence and formal training in this area remain uneven across care environments. A reliable scale gives educators and managers a way to identify gaps rather than relying on assumptions or anecdotal impressions.
Factor structure separates knowledge from attitudes
This methodological study formed a later phase of scale development and used an online survey of health and social care professionals between 2022 and 2023. The psychometric work focused on two core questions: whether the items hung together consistently, and whether the questions clustered into coherent domains rather than forming a single diffuse measure.
The final instrument settled into two knowledge-related factors and three attitude-related factors. The completed scale includes 30 knowledge items and 25 attitude items. For a field as sensitive as later-life sexuality, this separation matters because a person may possess factual awareness while still carrying discomfort, moral conflict, or uncertainty about clinical boundaries. Knowledge and attitude do not move in lockstep at the bedside.
Internal consistency was evaluated with McDonald’s omega and Cronbach’s alpha, and the final scale showed satisfactory reliability. Exploratory factor analysis supported the underlying structure. In practical terms, the tool appears coherent enough to use as a preliminary measure, although it is still at an early validation stage.
The sample was small, but the pattern was clinically recognizable
A total of 98 participants took part. The participant group was described as predominantly female, largely made up of registered nurses, and mainly working in aged care. They also demonstrated high levels of knowledge and positive attitudes toward later-life intimacy and sexuality.
That profile is informative because it suggests the scale was tested in a workforce already familiar with aged care realities, rather than in an entirely general population of staff. Even in that relatively engaged group, the need for a formal instrument remains obvious. Staff may support the principle of dignity in later-life relationships, yet still lack the confidence to assess consent in dementia care, respond to family concerns, or navigate gender diversity with consistency.
The findings also speak to a broader clinical tension. Policies often speak in general terms about person-centered care, but everyday decisions are made by frontline professionals who need language, structure, and training. A scale such as HSCP-KALLIS can help translate abstract values into measurable competency domains.
Dementia care and gender diversity make the measurement problem more urgent
Later-life intimacy is not limited to straightforward relationship counseling. In long-term care and geriatric practice, the topic frequently overlaps with cognitive impairment, guardianship, safeguarding, and institutional policy. When dementia enters the picture, staff must weigh autonomy against protection, and those decisions are rarely formulaic.
The inclusion of older adults with dementia and people from diverse gender backgrounds broadens the clinical relevance of the instrument. It acknowledges that sexuality in later life is shaped by more than age alone. Cognitive status, identity, prior relationships, social stigma, and staff bias can all influence how care is delivered. A measurement tool built without those dimensions would miss much of the real-world complexity.
There is a bedside consequence to that gap. If professionals are unsure how to interpret a resident’s affectionate behavior, how to support privacy, or how to respond when a same-sex relationship develops in care, institutional practice can default to caution, inconsistency, or unnecessary restriction. A validated scale cannot solve those problems by itself, but it can identify where training is most needed.
Preliminary validity supports training and policy use, with caution
The authors concluded that the HSCP-KALLIS scale provides preliminary evidence of reliability for measuring knowledge and attitudes toward later-life intimacy and sexuality. The instrument may be useful for identifying training needs, evaluating whether education changes staff confidence or understanding, and informing policy and guideline development.
That promise is real, but it remains bounded by the study design. The validation work was methodological rather than outcome-based, and the sample size was limited. Those constraints matter because a scale that performs well in one group can behave differently in a larger or more diverse workforce. Confirmatory factor analysis in a bigger sample will be the next necessary step before the tool can be treated as firmly established.
Still, the clinical rationale is strong. Care settings routinely assess pain, delirium risk, fall risk, pressure injury risk, and medication burden. Intimacy and sexuality rarely receive the same systematic attention, even though they are part of quality of life, identity, and personhood. A dependable instrument gives researchers and educators a way to bring this domain into routine quality improvement work.
A measurement tool cannot replace training, but it can expose the gaps
The most useful role for HSCP-KALLIS may be as a mirror for workforce readiness. If scores reveal uncertainty around dementia-related consent, discomfort with diverse sexual identities, or weak knowledge of later-life intimacy, educators can target those areas directly instead of offering generic gerontology training.
The scale may also help organizations evaluate whether education changes practice over time. A single workshop can raise awareness, but sustained improvement requires evidence that knowledge and attitudes actually shift. Without a tool, that change is hard to quantify.
For now, the validation remains preliminary, and the study’s small sample leaves room for further testing in broader clinical and social care populations. The next phase will need to show whether the factor structure holds when the instrument is used outside the original development sample and whether it performs reliably across different professional roles and care settings.