Sexuality In Later Life Research Articles

Sexuality in Older Adults: Comprehensive Strategies for Clinicians and Patient-Centered Care

Introduction: Healthcare providers play a crucial role in promoting sexual health among older adults, an important yet often neglected aspect of aging well. Although sexuality evolves beyond the reproductive years, it remains a meaningful part of life for many. Despite the natural decline in sexual activity with age, numerous older adults continue to value and engage in fulfilling sexual relationships. Unfortunately, targeted interventions to support later-life sexuality are lacking, creating gaps in care. Intervention: Sexuality in older adults is influenced by biological, psychological, and social factors. Clinicians should include comprehensive sexual health assessments, including STI screenings, as part of routine care. Providing age-appropriate sexual education and resources helps promote lifelong sexual wellness. Open communication between healthcare providers and patients is vital for addressing sexual concerns, often left unspoken due to stigma or discomfort. Additionally, adopting lifestyle medicine principles—such as balanced nutrition, regular exercise, stress management, and social connection—can enhance sexual health and overall well-being. Conclusion: Specialized training for healthcare professionals on the unique aspects of older adult sexuality is essential to bridge knowledge gaps. A holistic, evidence-based approach will empower providers to better support the evolving sexual health needs of older adults, improving their quality of life.

Review of HIV, Sex and Sexuality in Later Life

Review of <i>HIV, Sex and Sexuality in Later Life</i>

Sex and concepts of sexuality influence sexual problems and help-seeking behaviours of older people

In this study, we aimed to examine the prevalence, associated factors, and management of sexual problems in older people at a primary care unit. We recruited people aged 60 years old and over, who visited the Primary Care Unit of Songklanagarind Hospital, a tertiary-care and referral centre in Southern Thailand, between June and August 2021, and used a self-administered questionnaire on sexuality, sexual problems, help-seeking behaviours, and clinical consultations for sexual problems in older people. There were 190 participants in this study (120 women, 70 men, mean age = 68.3). One hundred and five (55.3%) participants reported having sexual problems. Compared to their female counterparts, males were more likely to have sexual problems (adjusted OR = 3.11; 95% CI = 1.52,6.34; p-value = 0.001). The majority (77.3%) considered non-penetrative sexual activities (outercourse) when discussing sexuality in later life, and they had lower odds of having sexual problems compared to those who relied purely on sexual intercourse (adjusted OR = 0.27 for only outercourse and 0.30 for both intercourse and outercourse; p-value = 0.016). Only 2.1% (4/190) of participants reported that a physician had asked them about sexual problems. Participants reporting sexual problems (N = 105) often consulted their partners (25.7%) and friends (10.5%) or searched information from the internet (18.1%). According to this study, sexual problems in older people are common in primary care settings, but they tend to be poorly managed. Clinical discussions and interventions that are sensitive to gender differences and acknowledge the broadened concepts of sexuality in later life, e.g., encouragement to practice outercourse, may help improve sexual problems and well-being among older people.

Promoting sexual health in older adults: Findings from two rapid reviews.

Sexual health throughout the life course is increasingly recognised as important to maintaining one's overall health, wellbeing, and relationships. We aimed to provide an overview of the evidence on sexual health needs and sexual health promotion in later life. We undertook two rapid reviews, drawing on systematic review evidence. Searches were conducted in Epistemonikos. Studies were eligible if they reported evidence about the sexual health needs of, or sexual health promotion interventions for, people aged 50+ years. Evidence was quality assessed and summarised in a narrative synthesis. Fifteen systematic reviews were included in Review 1 (sexual health needs) and 12 in Review 2 (interventions). Key concerns and needs of older adults included the impacts of cultural stigma/misperceptions, barriers to sexual expression, and a need for tailored support in a welcoming environment. Key concerns and needs of health and social care professionals included mixed attitudes towards and knowledge of later-life sexuality and a need for more training and education. Approaches to promoting sexual health in later life included training and workshops for care home professionals, education for older people at risk of/living with HIV, and interventions to address sexual health-related symptoms of menopause. Gaps in the evidence from current reviews and methodological issues in primary studies were identified. Older people have specific needs relating to their sexual health. Health and social care professionals working with older people may benefit from education/training around sexuality in later life. Evidence on effective interventions and strategies is limited.

Young Adults’ Acceptance of Later-Life Sexuality Is Predicted by Their General Sexual Attitudes and Viewing Sex as Leisure

Ageism is entrenched in the contemporary Western society, rendering later-life sexuality negligible and limiting intergenerational understanding of lifespan sexual well-being. This cross-sectional study (1) measured young adults’ extent of knowledge and attitudes toward later-life sexuality, general sexual attitudes, and sex as leisure views and (2) tested whether knowledge about elderly sexuality, gender, sexual attitudes, and sex as leisure views explain/predict attitudes toward later-life sexuality. Data were collected using survey methodology (N = 270; 55.2% women) and analyzed with descriptive statistics and multiple regression. Young adults reported medium knowledge levels and relatively tolerant/permissive attitudes toward later-life sexuality. They also tended to have permissive general sexual attitudes and to view sex as leisure. In turn, young adults’ general sexual attitudes and viewing sex as leisure predicted their acceptance of later-live sexuality, while gender and knowledge levels did not. These findings address meaningful knowledge gaps and contribute to sexual health education combating ageism.

The Aesthetics of Aging: Visual Strategies and Narrative Form in Tanizaki'sDiary of a Mad Old Man

AbstractThis essay reads Tanizaki Jun'ichirō’s controversial novel Diary of a Mad Old Man (1961) for its contribution to discourses about aging masculinity and male sexuality in later life. The Diary meditates on the mental and physical vicissitudes of aging masculinity, arousal, control, and impotence, focused through the fictional diarist Utsugi's physical ailments and expression of libidinal intensities. The article argues for Tanizaki's depiction of male aging as an exercise in both disenfranchisement and agentive potential. First, it reads the aging process through aesthetic and visual strategies, which magnify the protagonist's cultivation of masochistic pleasure as a specific correlative of aging. The article demonstrates that the narrative uses the rhetoric of cinema and photography—central terms of reference in Tanizaki's work—to frame Utsugi's experiences of old age, and inform his erotic fantasies as stylized, staged performances. In conjunction with these visual modes, the novel draws on traditional Japanese aesthetics to conceptualize the potential affect and perverse empowerment of the aging experience. Second, it addresses the implications of narrative form, as the self-reflexive, first-person diary prioritizes the subjectivity of Utsugi's male old age, while the novel's final pages interrupt and thus alter the diary's significance as a private account of self-expression.

Sexuality, Disability, and Aging: Queer Temporalities of the Phallus

Sexuality, Disability, and Aging: Queer Temporalities of the Phallus

Aging and Loving: Christian Faith and Sexuality in Later LifeJames M.Child's, Jr.Minneapolis: Fortress Press, 2021. 150 pp. ISBN: 978‐1‐5064‐6641‐5 (paper); 978‐1‐5064‐6642‐2 (eBook). $21.00.

DialogEarly View BOOK REVIEW Aging and Loving: Christian Faith and Sexuality in Later Life , James M. Child's, Minneapolis: Fortress Press, 2021. 150 pp. ISBN: 978-1-5064-6641-5 (paper); 978-1-5064-6642-2 (eBook). $21.00. Ernest L. Simmons, Corresponding Author Ernest L. Simmons [email protected] orcid.org/0000-0003-3588-841X Concordia College, Moorhead, Minnesota, USA Correspondence Ernest L. Simmons, Concordia College, Moorhead, MN 56562, USA. Email: [email protected]Search for more papers by this author Ernest L. Simmons, Corresponding Author Ernest L. Simmons [email protected] orcid.org/0000-0003-3588-841X Concordia College, Moorhead, Minnesota, USA Correspondence Ernest L. Simmons, Concordia College, Moorhead, MN 56562, USA. Email: [email protected]Search for more papers by this author First published: 14 February 2023 https://doi.org/10.1111/dial.12784Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Couples living with Alzheimer's disease talk about sex and intimacy: A phenomenological qualitative study.

To obtain a deeper understanding of the phenomenon of sexuality within the couple relationship when one of the partners has received a diagnosis of Alzheimer's Disease. This study aimed to listen to the voices of both partners, and to investigate how their intimate relationship has been impacted by an Alzheimer's diagnosis. This study adopted a qualitative phenomenological approach, and the method used was Interpretative Phenomenological Analysis. The data was collected based on interviews with six couples, where one of the spouses had a mild to moderate Alzheimer's diagnosis. The interviews were recorded and transcribed, and a detailed analysis of each interview was performed. From the detailed analysis of the transcribed interviews, six main themes emerged: Sexual expression today; Alzheimer's and sexuality; desire to be a sexual being; different sexualities; sense of couplehood; and uncertain future. The findings of this study provide a deeper insight into experiences of sexuality for couples living with Alzheimer's. Sexuality and intimacy of couples living with Alzheimer's continues to be an important aspect of the relationship, and in general, the partners wish to have the opportunity to express their sexuality. The construction of a sense of couplehood during the marriage tends to be a significant factor to sustain the changes that arise in the intimate relationship because of the diagnosis. However, despite the growing recognition of the existence and importance of sexuality in later life, persons with Alzheimer's have only recently starting to be recognized as sexual beings who wish to be heard.

Aging and Loving: Christian Faith and Sexuality in Later Life, by James M. Childs Jr.

Aging and Loving: Christian Faith and Sexuality in Later Life, by James M. Childs Jr.

TAILORED INTERNET-BASED SEXUAL EDUCATION FOR OLDER ADULTS: NEEDS ASSESSMENT AND ALGORITHM DEVELOPMENT

Abstract Many older adults are sexually active, but ageism fuels the neglect of older adults' sexuality in research and sexual education. The purpose of this study was to (1) assess older adults’ willingness to adopt technology tools to receive innovative, tailored sexual health education via the internet, (2) investigate their sexual health needs, and (3) contribute to development of an assessment tool and tailoring algorithm. Tailoring is a precision approach that matches educational content to users’ needs instead of offering the same suboptimal one-size-fits-all content to everyone. We conducted an online survey using Qualtrics research panels of older adults (N = 836, with equal representation by gender and balanced representation in each 5-year cohort from age 60 to 80+). We found that 30% reported they were likely to try tailored internet-based education for older adults; an additional 34% were unsure. The results establish priority areas in sexual health needs, including behavioral patterns, knowledge gaps, health-related constraints, and attitudinal and communicational issues. These components provide the basis for the tailoring assessment questionnaire. Respondents also rated the personal relevance of 28 educational modules covering sex in later life (e.g., sexual ageism, sex as quality-of-life issue, sex-related communication, body image, health conditions, gender-specific issues, sexual attitudes, broadening sexual definitions and repertoires, sexual adaptations, inhibitions, sex aids/toys/robotics, medications/treatments, orgasm, self-stimulation/masturbation, dating, risk-taking, celibacy, LGBTQIA+, sexual rights, abuse). Statistical relationships between sexual health needs and personally relevant modules contribute to the development of a tailoring algorithm for creating educational bundles matched to older adults’ unique needs.

Blueprint for Future Research Advancing the Study of Sexuality, Gender, and Equity in Later Life: Lessons Learned From Aging With Pride, The National Health, Aging, and Sexuality/Gender Study (NHAS).

While interest in sexuality\research is growing, in the past, it has been largely invisible in gerontology. By exploring the full range and dimensions of sexuality and their interrelationships with multiple factors, this article presents conceptual, substantive, and methodological advances for the field of sexuality in later life. Based on the Sexual Equity Framework, an extension of the Health Equity Promotion Model, this article highlights the heterogeneity and intersectionality of sexuality across the life course, examining how historical and contemporary contexts frame key dimensions of sexuality at multiple levels (intrapersonal, interpersonal, sociocultural, and structural) and their relationship with sexual quality of life. Utilizing findings from Aging with Pride: National Health, Aging and Sexuality/Gender Study, the heterogeneity and intersectionality of age, gender, race, and ethnicity are critical to understanding sexuality and its dimensions in later life. Many adults experience changes in sexual and gender identities over time. Affirming sexual and gender identities, social connections, and health-promoting behaviors are positively associated with sexual quality of life, while sexual stigma and marginalization have adverse consequences. The study of sexuality needs to be fully integrated into gerontology. The Sexual Equity Framework explicates the potential deleterious effect of historical and contemporary structures on sexuality as well the important roles of affirmation, agency, and resilience among older adults, and recognizes the important role of human rights to advance sexual quality of life. Important directions for future research, practices, and policies are outlined.

Palliative Care Professionals' Perceptions and Communication About Sexual Expression of Older Adults at End of Life: How Biases Compromise Holistic Care.

The sexuality of older people, which has historically been invisible, is increasingly represented and promoted in the media. However, the sexuality of the oldest older adults showing signs of frailty remains obscure and subject to ageist and ableist biases. Studies on sexual expression at the end of life have shown that sexuality and the need for support related to it remain important for many people. This article examines the perceptions and attitudes of professionals regarding the sexuality of older adults in palliative care, based on an exploratory qualitative study. Participants were recruited from several palliative care teams working either in hospital or in home settings in Canada. Professionals (n = 16) held two main views of sexuality: broad and holistic or narrow and genital-focused. Perceptions of sexuality in later life were either described as a continuation of or distinct from middle adulthood. No matter what views were held, most professionals did not discuss sexuality with their patients at the end of life. The lack of communication about sexuality may be largely due to professional's ageist, ableist, and heterosexist views regarding the sexuality of this population group. Results confirm the relevance of providing palliative care training about diverse sexual experiences and the importance of supporting older adults at the end of life with respect to their intimate and sexual needs. Such an approach is in line with the holistic vocation of palliative care.

Discomfort in Discussing Sexual Issues: Developing a New Scale for Staff at Long-Term Care Facilities for Older Adults.

Interviews reveal that many health professionals working with older adults are uncomfortable discussing sexual issues with those under their care. Nevertheless, to date, discomfort in discussing sexual issues with older adults has not been empirically investigated. To facilitate exploration of this subject, the current study evaluated the psychometric properties of a new measure: The Discomfort in Discussing Sexual Issues (DDSI) with Older Adults scale. The study was conducted via online survey among 127 long-term care staff (e.g., nurses, physicians, physical therapists, social workers, speech therapists, occupational therapists) serving older adults. A confirmatory factor analysis confirmed the DDSI scale's structure as a single, four-item construct. More conservative attitudes regarding sexuality in later life were associated with higher DDSI scores. In addition, DDSI scale scores were negatively correlated with knowledge about sexuality in later life and educational level. Findings indicate that the DDSI has good psychometric properties, as reflected by its high reliability and adequate validity, making it a useful assessment tool for future research. [Journal of Gerontological Nursing, 48(9), 27-37.].

Sexual Activity and Satisfaction in Older Adult Dyads: The Role of Perceptions of Aging.

This study assessed the associations between perceptions of aging (POA) and sexual frequency and satisfaction in older adult dyads. Using dyadic data from up to 1,122 different-sex married and cohabiting couples ages 50-89 (Mmen = 66.63 [7.40]; Mwomen = 64.43 [7.27]), we estimated 2 actor-partner interdependence models. We first examined the association between men's and women's POA and each partner's reports of frequency of partnered sexual activity (e.g., intercourse, oral sex, kissing, petting, and fondling). Then, we tested the link between POA and each partner's sexual satisfaction. Actor effects were detected in both models. Both men's and women's positive POA were associated with their own reports of more frequent sexual activity and greater satisfaction with their sex lives. These findings provide insight into how positive views on aging relate to older couples' sexuality. Future research should consider how attitudes shape later-life sexuality over time.

How Do Women and Men Negotiate Sex in Later Life Relationships? A Qualitative Analysis of Data from the English Longitudinal Study of Aging

ABSTRACT Later life relationships and in particular the role of sex within them, have often been neglected in research due to assumptions of decline and sexlessness. We contribute to a growing body of work which counters these stereotypes by examining sexual scripts within the socio-cultural context of later life relationships. We analyzed open-text comments from the English Longitudinal Study of Aging (ELSA) collected as part of a self-completion questionnaire. In Wave 6, 1065 participants (M age 67.5, SD 9.6 years) and in Wave 8, 922 participants (M age 69.1, SD 9.01 years) responded to an open-text box question. Across both waves, 38% of respondents were men and 62% were women. The analysis used a coding template developed from existing literature and adjusted to accommodate emerging topics. A gendered analysis of the interrelated topics of relationships, sex and sexuality resulted in themes which illustrate similarities and differences in how men and women negotiate sex in later life relationships. The findings confirm that sex remains integral to intimacy in later life relationships for many men and women. However, they also demonstrate that norms of age and gender interact to shape sex and relationship practices in later life. These norms limit some people’s experiences, for example, preventing them from seeking new relationships, as well as creating challenges for intimacy in partnerships. These findings extend the theoretical understanding of relationships and sex in later life.

Age Effects on Women’s and Men’s Dyadic and Solitary Sexual Desire

While most studies on sexuality in later life report that sexual desire declines with age, little is known about the exact nature of age effects on sexual desire. Using self-reported dyadic sexual desire relating to a partner, dyadic sexual desire relating to an attractive person, and solitary sexual desire from a large (N > 8000) and age diverse (14.6–80.2 years) online sample, the current study had three goals: First, we investigated relationships between men and women’s sexual desire and age. Second, we examined whether individual differences such as gender/sex, sexual orientation, self-rated masculinity, relationship status, self-rated attractiveness, and self-rated health predict sexual desire. Third, we examined how these associations differed across sexual desire facets. On average, the associations between age and both men and women’s sexual desire followed nonlinear trends and differed between genders/sexes and types of sexual desire. Average levels of all types of sexual desire were generally higher in men. Dyadic sexual desire related positively to self-rated masculinity and having a romantic partner and solitary desire was higher in people with same-sex attraction. We discuss the results in the context of the evolutionary hypothesis that predict an increase of sexual desire and female reproductive effort prior to declining fertility. Our findings both support and challenge beliefs about gender/sex specificity of age effects on sexual desire and highlight the importance of differentiating between desire types.

Reasons people refrain from sex in later life

There has been an increase in research on sexual activity in later life, yet far less is known about the actual perceptions and experiences of older adults who refrain from sexual activity. In the current study, a thematic analysis was conducted to identify patterns in semi-structured interviews with 47 older adults, aged 60-91. The analysis yielded seven themes that describe why older adults refrain from sex: 1) avoiding confronting sexual dysfunctions, 2) avoiding confronting the aging body, 3) avoiding performance anxiety, 4) being uninterested in sexual activity, 5) taking time to grieve the loss of a partner, 6) avoiding judgment, and 7) seeing sexuality as evolving and changing. Themes were organized according to the bio-psycho-social perspective and based on the axis of personal (self-focused) and interpersonal (partner-focused) motives. It is perfectly acceptable for people to refrain from sexual activity for their own reasons. However, if older adults want to remain sexually active, they should receive complete information about the many possibilities of treating different sexual problems in later life and about the many ways, beyond sexual penetration, one can enjoy sexual activity even in old age.

Do Sexual Expectations Matter for Older Men and Women? Anticipated Sexual Futures and Late-Life Sexuality Over Two Decades.

Expectations across a variety of life domains appear to shape the aging process, giving weight to the role of self-fulfilling prophecies in later life. Sexuality is one area where the power of expectations is not well-understood. We investigated whether 10-year sexual expectations were associated with sexual satisfaction and sexual frequency a decade on among older heterosexual coupled adults. We further examined whether sexual expectations could offset the sex-constraining impact of functional limitation onset. We used 3 waves of the Midlife Development in the United States study (1995, 2005, 2014), a nationally representative panel survey. Analyses consider adults aged 45+ in 1995 who had a spouse or romantic partner at 2 consecutive waves. Associations between sexual expectations and eventual sexual satisfaction and frequency were estimated with multivariable generalized estimating equations. Moderation analyses examined whether between-wave onset of functional limitations had less influence on sexuality outcomes when combined with a high initial level of sexual expectations. Sexually optimistic participants reported more sexual satisfaction and higher sexual frequency a decade later. Though the onset of functional limitations tended to suppress sexual frequency for women, the probability of having weekly sex was significantly higher among such women if they had high rather than low sexual expectations. Results suggest that, similar to other life domains, expectations shape the sexual experience of older adults. Clinicians and care providers may consider ways to help foster realistic optimism about sexuality among older men and women.

The Role of Information in Later-Life Sexuality: An Invitation for Further Exploration.

Despite the key role of information in realizing, questioning, or respecting one's sexual health, individuals' engagement with information about sex and sexuality remains understudied, particularly in older adult populations. Beginning with current understandings of later-life sexuality to contextualize how older adults may need, use, and manage information about their sexual lives and practices, this forum article follows with what is currently known about older adults' sexuality-related information needs and practices. We conclude with an invitation for collaboration between gerontologists and Library and Information Science scholars and professionals as a means to step outside the medicalization of older adults' sexuality and bolster our understandings of how information and later-life sexuality are mututally shaping.