Despite the aging of the population, little is known about the sexual behaviors and sexual function of older people. We report the prevalence of sexual activity, behaviors, and problems in a national probability sample of U. The unweighted survey response rate for this probability sample was Among respondents who were sexually active, about half of both men and women reported at least one bothersome sexual problem. Fourteen percent of all men reported using medication or supplements to improve sexual function.
National Centers. The confidence interval is based on the inversion of Wald tests constructed with the use of Aging sexuality and public policy standard errors. Steinke, E. Inappropriate sexual behaviors in cognitively impaired older individuals. These questions will help to initiate a discussion on sexuality and older adults. Urol Clin North Am. What do you think are the main teaching points in educating older adults about sexual issues?
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We need a comprehensive set of key variables e. Vitrual sex games reductions in publjc may be attributable to limited capacity or limited access. From the Minnesota State Legislature and the Minnesota Department of Corrections to elementary schools and workplaces, we provide accurate information to increase understanding, set precedents for sexual rights, and reduce social stigma. Policy Matters. Instructions on pbulic Aging sexuality and public policy toolkit for other than personal reading. Health equity and aging of bisexual older adults: Pathways of risk and resilience. This website features nursing standard practice protocols on issues of sexuality and aging. Their aging initiative is in place to raise awareness of the needs Sexualith the aging GLBT population through research, networking, and training. Of particular interest are collaborations among professionals in public health, planning, and transportation. Satariano directed the project. Email alerts New issue alert. Advocacy and Public Policy. Article Contents.
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Francis Road, Off S. The present review aims to throw some light on the various aspects of sexuality in older adults and the challenges faced by medical professionals working in this area.
Keyword searches using the terms "sexuality," "sexual dysfunction," "geriatric," "old age," and others in combination were carried out on PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews. Relevant clinical trials, case studies, and review papers were selected. This was further supplemented with the clinical experience of the authors, who work with older patients in a psychiatric outpatient setting with a dedicated sexual disorders clinic.
Sexuality is a lifelong phenomenon and its expression a basic human right across all ages. However, the construct of normalcy for sex in aging is blurred, with agism playing a distinct role. Older adults face much stigma when expressing sexual desires or concerns, both from their own families and the health-care system.
Sexual dysfunctions due to comorbid medical illnesses and medications are often treatable. Evidence-based treatments for sexual dysfunction in the elderly, lesbian, gay, bisexual, transgender, and queer, and other orientations are especially underrepresented in research; available research has several limitations.
Sexuality in people with dementia and sexual rights in nursing homes are gray areas. Medical training, treatment guidelines, and health-care facilities all need to be stepped up in terms of awareness and quality of care provided to the elderly with concerns related to sexuality. Advanced Search. Sexual interest and behavior in healthy to year-olds.
Arch Sex Behav ; How to discuss sex with elderly patients. J Fam Pract ;E Eysenck HJ. Sex and Personality. London: Open Books; Personality and sexuality. Pers Individ Dif ; Kessel B. Sexuality in the older person. Age Ageing ; Taylor A, Gosney MA. Sexuality in older age: Essential considerations for healthcare professionals. Das SK. Situation analysis of the elderly in India.
Ingle GK, Nath A. Geriatric health in India: Concerns and solutions. Indian J Community Med ; Gelfand MM.
Sexuality among older women. Sexuality and quality of life. J Gerontol Nurs ; Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan.
J Clin Nurs ; Butler RN. Across Board NY ; Levy B, Langer E. Aging free from negative stereotypes: Successful memory in China and among the American deaf. J Pers Soc Psychol ; Kaplan HS. Sex, intimacy, and the aging process. J Am Acad Psychoanal ; Sexual function in the elderly. Arch Intern Med ; A study of sexuality and health among older adults in the United States.
N Engl J Med ; Hillman JL. Clinical Perspectives on Elderly Sexuality. US: Springer; Nelson TD. Massachusetts: MIT Press; Sexual disorders among elderly: An epidemiological study in South Indian rural population. Indian J Psychiatry ; Sexuality, health care and the older person: An overview of the literature. Int J Older People Nurs ; Schiavi RC. Sexuality and aging in men. Annu Rev Sex Res ; Sexuality: Desire, activity and intimacy in the elderly.
Martin CE. Factor affecting sexual functioning in year-old married males. Sexual activity and aging. J Am Med Dir Assoc ; Sharpe TH. Introduction to sexuality in late life. Fam J ; Eur Urol ; Mulligan T, Moss CR. Sexuality and aging in male veterans: A cross-sectional study of interest, ability, and activity.
Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab ; Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology. Maturitas ; Janus S, Janus CL. The Janus Report on Sexual Behavior. New York: Wiley; Basson R, Schultz WW. Sexual sequelae of general medical disorders. Lancet ; Barriers to the expression of sexuality in the older person: The role of the health professional.
Sexual dysfunction in the elderly: Age or disease? McNicoll L. Issues of sexuality in the elderly. Med Health ; An update on female sexual function and dysfunction in old age and its relevance to old age psychiatry.
Aging Dis ; Raboch J. Sexual development and life of psychiatric female patients. Psychiatric morbidity is frequently undetected in patients with erectile dysfunction. J Urol ; Predicting and preventing adverse drug reactions in the very old.
Drugs Aging ; Gever LN. Drugs and sexual dysfunction. Nursing ;
Loss of independent mobility can be immediate and catastrophic e. What makes you uncomfortable when you talk with your clients about issues of sexuality? First, limitations in walking and driving reduce access to goods and services, which leads to poor health outcomes. Seeman TE. A model curriculum for a course on the built environment and public health: training for an interdisciplinary workforce.
Aging sexuality and public policy. You are here
Sexuality in Later Life
Contemporary Perspectives on Ageism pp Cite as. Older people are challenged by ageist attitudes and perceptions that hinder their sexual expression. They are stereotyped as non-sexual beings who should not, cannot, and do not want to have sexual relationships. Expressing sexuality or engaging in sexual activity in later life is considered by many in society as immoral or perverted. False expectations for older people also stem from ideals of beauty, centralization of the biomedical perspective on sexuality of older adults, and the association of sex with reproduction.
Unfortunately, older people internalize many ageist attitudes towards sexuality in later life and become less interested in sex and less sexually active. The following chapter explores attitudes towards sexuality in later life among the media, young people, older people themselves, and care providers.
In order to enable older people to express their sexuality and sexual identity freely and fully, awareness of ageist perceptions must be raised and defeated. In contemporary society, sexuality, intimacy, and sexual identities are considered central to a meaningful personal life, and on a fundamental level, constitute one of our basic human needs and rights.
Until relatively recently however, much of the literature and discussion on these issues tended not to acknowledge older people and the topic remained taboo. This chapter explores some of the dominant discourses about sexuality, intimacy, and sexual identities in later life. This holistic definition articulates sexuality as a state of being beyond sexual activity or sexual relationships. It includes notions of intimacy where there is close association, familiarity and shared personal knowledge between people, suggesting a degree of caring, sympathy or emotional understanding.
The notion of sexual identity or sexual orientation adds complex dimensions, which may include political and community elements of how people relate to one another.
Researchers are also beginning to note greater fluidity in sexuality over the life span, further complicating our definitions of sexual identities, including gender identities, which may not coincide with sexual orientation Willis et al. The media has an important role in shaping the public image of later life and sexuality. DeLamater and Koepsel The voices presented in the media frequently contradict. There is a repeated assertion that sexuality continues to play an important role as people age Scherrer Yet, older people who remain sexually active are stereotyped by the popular media, as well.
Due to the emphasis on youthfulness by mass media, older men and women are underrepresented in advertisements. Images of older people relating to specific advertisements, such as pensions or health care products are associated with notions of burden frailty, loneliness or vulnerability Media and diversity in an ageing society, — , which reflect stereotypical expectations about later life Prieler ; Williams et al. The dominant, idealized notion of remaining young-looking, physically attractive and sexually active was highlighted, which marginalized older people who chose not to conform to that ideal or were unable to do so.
This dominant ideal alongside with the successful ageing paradigm that encourages older people to stay sexually active, have led to a reconstruction of sexuality in later life. The representations of older people in print media established and reinforced the paradox that while sexuality is crucial to remaining youthful and aging successfully, youth and beauty are essential requisites for active sexual engagement.
Wada et al. Older people are expected to use pharmaceutical and medical interventions to sustain and enhance sexual functioning Wada et al. Emphasizing heterosexual ideals e. This creates an artificial distinction between the third age and the fourth age, when older people are seen as becoming non-sexual Wada et al. The consequence of the divergence between the third and the fourth ages is growing stigmatization and ageism towards people as they grow older.
The subtext underlying this type of advertising portrays older people as unattractive. It seems that despite the increasing recognition by mass media of older people as sexual human beings, ageing is still presented in a very narrow and one-dimensional mode.
As a result, sexual desire and enjoyment, achieving orgasm and frequency of sexual activity might diminish Koch et al. Studies have indicated that younger adults have accepting, tolerant, open-minded and positive attitudes towards sexuality in later life Allen and Roberto ; Freeman et al.
A survey of college students regarding their sexual attitudes and behaviors, both currently and projecting into later life, found that although younger adults were optimistic about continued sexual enjoyment in later life, they also believed many of the current myths about ageing.
They expected considerably diminished sexual activity, along with increased sexual problems. Nonetheless, explicitly ageist attitudes toward sexuality might be difficult to detect Thompson et al. Evidence for this was found in a study that used an implicit attitudes test, which operates beyond conscious awareness Lai and Hynie Participants perceived older people to be significantly less interested in sexual activities than were younger generations.
Another study Thompson et al. The authors reported that, consistent with other contemporary research Lai and Hynie , when asked, young adults explicitly reported positive views about the sexuality of older people; however, implicit attitudes towards sexuality and ageing were negative.
It shapes the way you experience life, your interests, likes, dislikes, humor, friendship, and attitudes. In summary, attitudes held by the younger generations towards older people are important, as they potentially impact their behavior toward older people, as well as the beliefs and attitudes of older people towards sexuality.
Findings from a study conducted in Nigeria, revealed that older people portray sexuality as an important aspect of later life, with heterosexual intercourse construed as having physical and spiritual consequences Agunbiade and Ayotunde A particularly significant indication of internalizing ageism is the reluctance of older people to discuss sexual issues with their primary care physician, due to fear that sex in later life does not meet with societal expectations and therefore, might be disapproved of by healthcare providers Gott and Hinchliff Implicit in many stories was the perception that older people are not or should not be sexual beings.
In an attempt to combat ageism, older people undergo many beauty and anti-ageing treatments Vares and consume pharmaceuticals aimed to enhance sexual performance Gledhill and Schweitzer ; Katz and Marshall ; Wentzell Unfortunately, beauty and anti-ageing treatments and pharmaceuticals to enhance sexual performance do not always lead to satisfaction.
Older people reported pharmaceuticals were often prescribed without assessment of the factors involved and without warning of side effects. They found pharmaceuticals aimed to enhance sexual performance ineffective and costly Gledhill and Schweitzer Similarly, older women, who knew about vaginal lubricants, said that they felt that sex was still physically uncomfortable even when using lubrication Shea Shea opined that expanding the notion of sexuality beyond sexual intercourse is necessary.
Absence of sexual activity may reflect a desire for liberation from sexual obligations, an acceptance of changing circumstances or the informed choice of other social priorities.
Specific, narrow societal norms and expectations were found to be main barriers to expressing sexual needs and sexuality, and to raising or discussing sexually-related issues with professionals.
Internalizing societal norms and ageism caused sexual problems that were attributed to ageing, to be viewed as normal and irreversible or untreatable Gott and Hinchliff Sexual activity in later life is closely linked to physical health, diseases and functional decline Dennerstein et al. Yet, physicians report they receive inadequate and insufficient education about sexuality in later life Dogan et al. Similarly, a study conducted among psychiatrists in the US Bouman and Arcelus found that sexual history is often omitted in the psychiatric assessment of older men.
Knowledge and attitudes towards sexuality in later life were positively linked in many studies Mahieu et al. Ageist attitudes are not uncommon among health care providers Dogan et al. A qualitative study conducted among general practitioners Gott et al.
In addition, sex was not recognized as an appropriate topic for discussion with older people. Nonetheless, no matter what the reasons for differential attitudes towards older people, it is clear that physicians exhibit strong biases in their approach to them. Attitudes towards sexuality in later life, among staff in long-term care LTC facilities, are very relevant to the level of sexual expression among residents Elias and Ryan ; McAuliffe et al.
Staff knowledge regarding sexuality in later life is limited Mahieu et al. Prior to entering care facilities, prospective residents are not provided with information about how their sexual and intimacy needs will be respected Bauer et al.
In addition, even though the majority of LTC staff believe residents have sexual needs that should be acknowledged and supported, the need was not regularly assessed due to discomfort about the topic among the staff, negative attitudes among the staff towards older people, as well as a lack of privacy and unclear institutional policy regarding the issue Gilmer et al.
Lastly, it should be noted, not all explicit, positive attitudes truly represent inner-thoughts or feelings Thompson et al. In a study conducted among LTC staff, respondents acknowledged the existence of negative reactions towards masturbation only among other colleagues. When asked for their own opinion, they stated they viewed masturbation as normal and acceptable behavior Villar and Serrat This can be particularly stressful when the person finds him- or herself in a care environment where they will inevitably have less personal freedom.
Education is an important factor in dispelling commonly held, negative views of residential care staff about older people expressing their sexuality. Thus, it is very important to provide this information to LTC and nursing home staff Bauer et al. Sexuality in later life remains a largely unexplored and taboo topic.
It is characterized by a dual nature and dominated by social constructivism. Despite recognition that sexuality is important to the quality of life of older people, this chapter identifies ageist perceptions regarding sexuality in later life among the media, young people, healthcare service providers and among older people.
Any discussion needs to deconstruct the myths and stereotypes that deny older people their own unique sense of sexual being and the right to express it McAuliffe et al. Rooted in and compounding ageism, are irrational fears, stereotypical thinking and lack of knowledge, resulting in attitudes and behaviors that constitute significant barriers to sexual expression, the enjoyment of sexuality and achieving a sense of self in later life Snyder and Zweig Surveys conducted in several countries consistently found that older people indicated the importance of remaining sexually active as a major component of their quality of life and well-being Kontula and Haavio-Mannila Research has shown that older people continue to engage in various sexual activities, such as penetrative sex, oral sex, and masturbation even in the eighth and ninth decades of life Lindau et al.
Hence, the expressed desire to remain sexually active is often accompanied by corresponding behaviors. Similarly, researchers have failed to challenge age-related stereotyping by placing older people outside the remit of national, population-based surveys on sexuality and sexual health issues, reinforcing the notion that these are not relevant to this sector of the community.
Sexuality is fundamental to social organization and is an important focus of power and resilience. Placing it at the center of an analysis of ageing and later life can provide insights into the possibilities of reworking the stereotypes and social practices that shape attitudes and subsequent actions when providing services and support.
Finally, until relatively recently, the research literature has tended not to acknowledge ethnic or cultural diversity. Concurrently, paradigms for active and successful ageing reinforce high expectations concerning sexual behaviors, activities and desire, which are often inconsistent with the reality of many older people Woloski-Wruble et al. Encouraging older people to stay sexually active in a way that is inconsistent with their reality, is another form of ageism DeLamater and Koepsel ; Marshall Although it is agreed that some sexual changes and dysfunctions can be due to hormonal and other physical changes or long-term conditions related to ageing Dennerstein et al.
A biopsychosocial model is a multidisciplinary approach to the diagnosis and treatment of sexual problems, as it considers psychological and social factors such as stereotypes, gender socialization, partner availability, socioeconomic status, ethnicity, religious beliefs, and sexual orientation, in addition to biological influences DeLamater and Sill ; Hillman Professional care providers including medical practitioners, nurses, social workers, psychologists and physical therapists are required to understand physiological and psychological factors that may impede the expression of sexuality in order to help older people manage sexual issues Hillman Older adults can incorporate negative perceptions towards older people, which might hinder sexual expression in later life.
Promoting realistic attitudes, alongside overthrowing ageist perceptions are required in order to enable older people to express their sexuality and sexual identity freely and fully. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Skip to main content Skip to sections. Advertisement Hide.
Open Access. First Online: 23 May Download chapter PDF. These assumptions sustain a language for discussing relationships and life in a heteronormative way Hafford-Letchfield