AIMS: This paper presents the results of a study that investigated nursing home staff perceptions of affectionate and sexual behaviour of residents. BACKGROUND: Despite growing recognition of the importance of sexual expression among residents and a increasing willingness to discuss the topic, sexual activity for nursing home residents remains an ignored component of life satisfaction. Even when 'sexuality' has been included as part of a resident's plan of care, this may not mean that attention has been paid to maintaining that aspect of their life. Thus, nursing homes can mark the end of many types of freedom for older people. Given that intimate basic care is performed by others and often by members of the opposite sex, loss of sexual freedom may also occur. METHOD: A grounded theory approach was used to study staff working in nursing homes in Australia and Sweden. Data were generated through interviews and nominal groups with nursing home staff. Thirty women volunteered to be interviewed, and 18 others were involved in the three nominal group discussions; a further five participants were involved as key informants. FINDINGS: Staff perceptions and responses to residents' sexual behaviour were found to be influenced by their own level of comfort related to sexuality issues, and the ethos within the organization where they worked. The conceptual paradigm was termed 'Guarding Discomfort' and specified the ways in which staff guard against sexuality discomfort as well as the ways their behaviour fits within different types of organizations. CONCLUSION: Both staff and nursing home managers need to work toward developing a home environment that is supportive of residents' sexuality rights, that permits sexuality expression and promotes a culture where all people concerned are comfortable with sexuality issues.