Chapter 26

Chapter 26: Sexual Function

Preconceived Ideas About Sex and the Older Adult

  • Understanding misconceptions about older adults and sexuality.

Introduction

  • Importance of sexuality in intimate relationships and quality of life.

Age-Related Changes Affecting Sexual Function

Changes Affecting Women

  • Hormonal changes: Menopause, perimenopause, postmenopause.

Changes Affecting Men

  • Andropause, late-onset hypogonadism, erectile dysfunction.

Risk Factors Affecting Sexual Function

Societal Influences

  • Myths, attitudes, and stereotypes regarding older adults and sexuality.

Medical Factors

  • Adverse drug effects (CNS depressants, circulation issues) and chronic conditions (pain, cancer, diabetes).

Functional Impairments

  • Conditions like COPD, arthritis, and urinary incontinence impacting sexual wellness.

Functional Consequences on Sexual Wellness

  • Changes in reproductive ability, sexual stimulation response, and interest; risks for dysfunction.

In-Office Treatment of STIs

  • Increase in treatment among older patients (2014-2017).

The Nursing Process: Sexual Function

  • Evaluation and implementation within nursing care.

Nursing Assessment of Sexual Function

  • Importance of creating a comfortable communication atmosphere.

Assessing Sexual Interest

  • Discuss factors without discomfort, using open-ended questions.

Cultural Influences

  • Variability in manifestations of menopause across cultures.

Describing Sexual Orientation and Identity

  • Definitions: heterosexual, bisexual, homosexual, gay, lesbian, transgender.

PLISSIT Assessment Model

  1. Permission - Initiate discussion on sexual topics.

  2. Limited Information - Provide basic education.

  3. Specific Suggestions - Offer tailored advice.

  4. Intensive Therapy - Address deeper sexual issues.

Nursing Diagnoses

  • Identify ineffective sexuality patterns and readiness for enhanced sexual knowledge.

Planning for Wellness Outcomes

  • Focus on client satisfaction, body image, and cultural needs fulfillment in long-term care settings.

Nursing Interventions to Promote Sexual Wellness

  • Challenge stereotypes about older adults and their sexual interests.

Teaching Older Adults About Sexual Wellness

  • Importance of addressing age-related changes, risk factors, resources, and STIs.

Consent for Cognitively Impaired Residents

  • Ensuring rights to intimacy and self-determination in care settings.

Teaching Interventions for Women

  • Addressing menopausal effects, infections, and pain during intercourse with specific interventions.

Teaching Interventions for Men

  • Understand erectile dysfunction and new treatment options.

Sexual Activity with Chronic Conditions

For Arthritis

  • Recommendations for managing pain and optimizing engagement in sexual activity.

For Cardiovascular Disease

  • Guidelines for safe sexual activity, including energy management and health considerations.

Evaluating Effectiveness of Nursing Interventions

  • Ensuring accurate information, improved quality of life, and better staff comfort with discussions of sexual health.

References

  • Miller, C. (2019). Nursing for Wellness in Older Adults (8th ed.). Lippincott Williams & Wilkinson.