Nursing 163

Understanding Sexuality in Older Adults

• Sexuality Defined:

  • Refers to a state of physical, emotional, mental well-being in relation to sexual activity.

  • It encompasses more than just the absence of disease or dysfunction.

• Common Misconceptions:

  • Many believe older individuals lose interest in sexual activity; this is a misconception.

  • Sexual health persists into old age, with interactions in long-term care facilities often demonstrating that older adults engage in sexual behaviors.

Sexual Health Essentials

• Positive Approach:

  • Emphasizes respect for sexuality, acknowledging enjoyable experiences free from coercion, discrimination, or violence.

  • Sexual needs are considered basic human needs, similar to food and water.

• Continuity of Sexuality:

  • Women cease to have children post-menopause while men remain fertile longer, potentially into their later years.

Factors Affecting Sexual Health

• Hormonal Changes:

  • Menopause:

    • Causes decreased progesterone and estrogen which can affect sexual desire and function.

  • Men’s Sexual Health:

    • A drop in testosterone can decrease libido and affect aggressive behaviors.

• Health Impacts:

  • Various health issues such as diabetes and hypertension can adversely affect sexuality, complicating the ability for physical interaction.

Sexual Response and Dysfunction

• Aging Effects:

  • Sexual response times slow down with age.

  • Long-term illnesses and advanced age can impede mobility, thus affecting sexual activity.

• Sexual Dysfunction:

  • More prevalent in females due to reduced sexual desire and pitfalls in reaching orgasm post-menopause.

  • Males often experience erectile dysfunction, particularly influenced by comorbidities like diabetes and hypertension.

Human Connection and Relationships

• Importance of Relationships:

  • Emotional bonds may overshadow sexual activity, with many seniors valuing companionship over sexual interaction.

• Difficulties with Intimacy:

  • Many factors, including loss of a spouse and subsequent loneliness, can impact sexual interest or readiness.

Medical Factors and Procedures

• Prolapse and Pain:

  • Conditions like pelvic organ prolapse can lead to discomfort during intercourse, along with vaginal dryness stemming from hormonal changes.

• Therapeutic Solutions:

  • Hormonal treatments or lubricants may alleviate some discomfort associated with sexual activity in older women.

STI Considerations

• Awareness of Risks:

  • There is a growing incidence of STIs, particularly among older adults. Education on safe practices remains crucial.

LGBTQ+ Considerations

• Sexual Orientation in Older Adults:

  • Sexual orientation has always existed, with older generations carrying experiences across diverse communities.

• Double Stigma:

  • Older LGBTQ individuals face unique challenges within health care settings, often affected by historical stigmas related to sexual orientation and elder care.

Best Practices for Caregivers

• Respect and Understanding:

  • Caregivers must balance respect for privacy and personal rights with sensitivity to residents' needs.

• Encouragement of Expression:

  • Fostering environments where older adults can communicate their needs or discomfort related to sexuality is essential.

  • Private discussions should be facilitated, ensuring adequate time is provided for older individuals to share their concerns about sexual and emotional needs.