163 3/3 lecture

Understanding Sexuality in Older Adults

• Sexuality is a complex interplay of physical, emotional, and social dimensions. It is not merely an absence of disease or dysfunction.

Common Misconceptions About Aging and Sexuality

• Many people believe that sexual desire decreases with age.

• Reality: Older adults can have active sexual lives, sometimes even more so as boredom may increase desire.

• Conditions like Alzheimer's or dementia can lead to a decrease in inhibitions, leading some older adults to express interest in sex more freely.

Sexual Health

• Defined as an approach that emphasizes positive and respectful attitudes toward sexuality, ensuring pleasurable and safe experiences free from compersion, discrimination, and violence.

• Acknowledges that sexuality is a basic human need, comparable to food and water, but lacks absolute necessity for survival.

Biological Factors Affecting Sexuality

• Women experience changes post-menopause, significantly reducing reproductive hormones like estrogen and progesterone.

• Men continue to produce sperm until death but may experience decreased testosterone levels.

• Aging can slow sexual response time and affect physical capabilities essential for sexual activity (dexterity, flexibility).

• Chronic health issues such as diabetes and hypertension can contribute to sexual dysfunction in both sexes.

Sexual Dysfunction

• More prevalent in women, particularly after menopause where hormonal changes may lead to a decreased desire and difficulty in achieving orgasm.

• Psychological factors, including anxiety and mood disorders, can also significantly impact sexual desire.

• For men, erectile dysfunction is a common issue often exacerbated by depression and medical conditions like diabetes and hypertension.

Physical Changes and Their Impacts

• Conditions like diabetes can lead to decreased sensation (neuropathy) and blood flow, complicating sexual function for men.

• Women may experience pelvic organ prolapse and vaginal dryness, leading to discomfort during intercourse.

• Medications, especially antidepressants and antihistamines, can also affect sexual desire and performance.

Cultural and Social Considerations

• The stigma surrounding sexuality in older adults, especially those in the LGBTQ+ community, prevents open discussions about their sexual health.

• Historical contexts, like the AIDS epidemic and civil rights movements, have influenced the comfort levels in discussing sexuality among older individuals.

Sexual Rights and Consent

• Older adults in long-term care have the right to manage their sexual lives without interference.

• Conditions like dementia may complicate issues of consent, necessitating careful considerations in sexual interactions.

• Staff and caregivers should respect individuals' privacy and be non-judgmental when addressing sexual needs.

Education and Awareness

• Essential for older adults to understand safe sexual practices, especially in the face of increasing STI rates amongst those over 50.

• Discussion around privacy, autonomy, and the impact of mental and physical health on sexuality should be ongoing.

• Encouragement of open dialogues can reduce stigma and foster a more supportive environment for the sexual health of older adults.