Sexuality and intimacy can be part of everyone’s life, whether they are teenagers or grandparents. Yet in our society the sexuality of older people has been ignored, hidden, and sometimes mocked. Myths prevail and sometimes dictate even how people feel about themselves. Despite this, just as attitudes about sexuality have changed for many areas, they are beginning to change regarding the topic of seniors and sex. This month, Elderpost discusses sexuality in older people.
Similar to all systems in the body, the reproductive system changes as people age. These changes may cause sexual dysfunction or difficulties during sexual activity which can lead people to “giving up” on sex. As well, sexuality at any age can become a challenge due to illnesses such as diabetes, arthritis, heart disease, or due to chronic pain, surgery, or medications. Help is often available, but shame and embarrassment can inhibit someone from talking to a doctor, physiotherapist or other health professional and seeking out the resources they need to cope.
There may be denial of senior’s sexuality at a societal level but the reality is that many seniors are sexually active. As well, their attitudes on sexuality and it’s importance mirror those of younger people.Numerous studies have confirmed that older people still find sex an important part of their lives and relationships, and that they are sexually active.
Being sexually active means seniors also need to behave in a sexually responsible manner. The topic of safe sex was not something they grew up with and is something with which they need to become familiar and comfortable. Sexually transmitted infections (STI’s), including AIDS/HIV, gonorrhea, chlamydia and others, are threats at any age and should be a concern for them just as it is for younger people. Seniors need to educate themselves about these conditions and about methods of protection which were not available when they were growing up and becoming sexually active.
Sexuality is about much more than intercourse. It is about emotional intimacy and simple touch–whether it is holding hands, a warm embrace,or cuddling on a couch. The need for these kinds of intimacy may be stronger than the need for the former, yet as people age, they often lose the opportunity for it due to death of a partner or decrease in mobility and socializing. Sexuality can also be about dressing well, flirting,looking good and humour. People need acceptance that the range of their needs and sexuality are valid.Equally important, they themselves need to accept whatever their needs may be.
For some people, the issue of their sexual identity and orientation may surface as they age. With children grown up and perhaps with the loss of a spouse or partner, they may be ready to begin to acknowledge being gay, lesbian, bisexual or transsexual (GLBT). Thoughts or actions which they repressed or hid earlier in their lives when alternative sexuality was less accepted may now be accepted and acted upon.They can find acceptance as well as peer support and resources in the GLBT community. At the same time, many people who have lived an openly gay/lesbian lifestyle face a particular crisis when they consider moving into Seniors Housing. The attitudes of other residents and staff can force them to choose going back into the closet, or even avoiding utilizing these otherwise appropriate resources.
Support for acceptance and expression of sexuality can happen in many ways.We need role models not just of “happy, healthy seniors” but of seniors whose sexuality is a part of their visible lives. Public discussion on radio and tv talk shows. We need to see the “normality” of seniors’ sexuality portrayed in movies and on TV in the same way that it is for people of any age. Programmes which promote healthy sexuality or which are aimed at preventing transmission of STI’s need to include older people in their target populations and in their publicity.
Assumptions and attitudes regarding seniors and sexuality also need to change at an institutional level. Staff at care facilities and seniors residences need training and awareness. Policies of residences and other agencies need to be examined and changed if necessary to reflect the need for and right to intimacy and sexuality of older people.
Professionals also need to examine their approach and attitude when dealing with seniors and sexuality. The assumption should be that the need and the activity is there. Doctors can learn to sensitively ask patients about sex and intimacy; counsellors need to address it. How are the patient’s needs for intimacy being met, and if they are not, what impact is it having on them? This acknowledges sexuality as just one of many spheres of someone’s life.
Changes at a societal level and at an individual level are facilitated when everyone looks at themselves and examines their own feelings and reactions to the idea of seniors, sex, intimacy and sexuality. They need to think about it in general and personally–with their parents, grandparents, and themselves. Everyone needs to acknowledge their discomfort if they have it and wonder why they have it and think about the reality of the basis for it.
In brief, at Elderpost and Diamond Geriatrics we believe that attitudes and values on sexuality and seniors should not be about “wondering if,” but “wonderful that.”