Sexuality In Later Life Research Articles

Sexual Health for Older Women : Implications for Nurses and Other Healthcare Providers = الصحة الجنسية للنساء المسنات : إنعكاساتها ممرضين و الممرضات و مقدمي الرعاية الصحية الأخرى

This article presents findings from a review of the evidence regarding sexual health for older women from MEDLINE, SCOPUS and the Cumulative Index to Nursing and Allied Health (CINHAL) databases. A total of 10 articles based on primary studies, reporting about the sexuality or sexual health of older women (and older people), and published between 2002-2012, were deemed suitable. The major themes that emerged from the available literature suggest that the sexual health of older people is affected by factors such as physical changes, mental health, changes to their relationship with their husband, chronic ill health and other psychosocial situations. It is concluded that nurses and other healthcare providers have a range of interventions that can be adopted to promote sexual health among older women. These interventions may focus on improving the older woman's sexual health assessment; increasing awareness and knowledge about sexuality in later life; pharmacological and psychotherapeutic therapies; using alternative techniques to achieve better sexual functioning; addressing partner and relationship issues, and advocating the importance of sexual health through media and policy development.

Sexuality in Later Life: Examining Beliefs and Perceptions of Undergraduate Students

Understanding students’ beliefs and perceptions of sex/sexuality in later life can reduce and prevent ageist myths and stereotypes. The objective of this study was to gauge undergraduate students’ knowledge of several myths, stereotypes, and facts regarding sex/sexuality in later life, including lesbian, gay, bisexual, and transgendered (LGBT) older adults. More than 85% of students held a positive view of sex/sexuality in later life with 65% believing that they would engage in sexual activity past age 80 (N = 125). Correct responses to true/false questions were higher for those with a positive perspective on aging, and recognizing that sexual behavior does not cease to be important with aging was the strongest predictor of holding a positive view on sexuality in later life. No significant differences were observed from responses regarding LGBT older adults or constraints to sexuality in long term care facilities. The positive perceptions among students in the current study suggest an increased acceptance of sexuality and diversity that should be maintained in university curricula.

Racial and socioeconomic disparities in sexual activity among older married Malaysians

Sexuality as an important part of life has not been well studied in Malaysia, particularly among older adults. The main aim of this study was to investigate the racial and socioeconomic differences in sexual activity among older married Malaysians. Data for this study consisting of 1036 older married adults aged 60 years and older were obtained from the nationwide community-based cross-sectional survey entitled “Determinants of Wellness among Older Malaysian: A Health Promotion Perspective”, conducted in 2010. Data were analyzed using SPSS version 21 for Windows. The results showed that 57.3% (95% CI: 54.3–60.3) of the respondents (61.6% of men and 50.6% of women) had engaged in sexual intercourse during the last 12 months. The adjusted multivariate logistic regression analysis revealed that ethnicity and educational attainment were independently and significantly associated with sexual activity, after controlling for the possible confounding effects of chronic medical conditions and demographic characteristics. The findings from this study do support the notion that sexuality is a lifelong need and cultural teachings and formal education may have important role in maintaining the quality of sexuality in later life.

Staff Knowledge and Perceptions of Sexuality and Dementia of Older Adults in Nursing Homes

Adults hold negative attitudes toward sexual expression in late life. We investigated knowledge and attitudes about older adult sexuality and dementia among staff in nursing homes (NHs). We acquired staff demographics, knowledge of dementia and sexuality, and attitudes of sexuality. Staff participated in focus groups and received continuing education credit. The three NHs had an average census of 178 beds. Participants' (N=100) mean age was 38.53. The most common type of sexual contact reported was nondemented male with nondemented female (67.5%), followed by demented male with demented female (53.6%). Participants endorsed neutral attitudes about late-life sexuality. Focus groups revealed a need for more training and effective interventions to balance resident safety and autonomy. Staffs' knowledge of sexuality and dementia, desire for guidance in "managing" sexual expression, and neutral attitudes toward late-life sexuality supports the need for educational interventions on sexuality and dementia in NH.

Nurses' knowledge and attitudes towards aged sexuality: validity and internal consistency of the Dutch version of the Aging Sexual Knowledge and Attitudes Scale

This paper reports a study testing the content and face validity and internal consistency of the Dutch version of the Aging Sexual Knowledge and Attitudes Scale. The ability of older residents to sexually express themselves is known to be influenced by the knowledge and attitudes of nursing home staff towards later-life sexuality. Although the Aging Sexual Knowledge and Attitudes Scale is a widely used instrument to measure this, there is no validated, Dutch translation available. Instrument development. Following a standard forward/backward translation into Dutch, the scale was further adapted for use in Flemish nursing home settings. Content and face validity and user-friendliness were assessed. The psychometric properties were determined by means of an exploratory study. Data were collected from March-April 2011 at eight Flemish nursing homes. Reliability was assessed using internal consistency and item-total correlations. Both subscales of the Flemish adaptation showed acceptable content validity. The face validity and user-friendliness were deemed favourable with hardly any remarks given by the expert panel. The Cronbach's α was 0.80 and 0.88 for the knowledge and attitude subscales, respectively. The item-total correlations ranged from 0.21-0.48 for the knowledge section and from 0.09-0.68 for the attitude subscale. We conclude from our study that the Dutch version of the scale has acceptable to good psychometric properties. The Flemish adaptation therefore seems to be a valuable instrument for studying nursing staff's knowledge and attitudes towards aged sexuality in Flanders.

A Review of the Literature on Sexual Development of Older Adults in Relation to the Asexual Stereotype of Older Adults

There is a prevalence of an asexual stereotype in regard to older adults. This paper reviews sexual development later in life from three different vantage points to explore why and how this stereotype exists. The vantage points are changes in social life, physical development, and psychological development. Older adults are often less engaged in society due to retirement, hence they have fewer opportunities to meet new partners. However now the internet is used a forum for older adults to meet new partners, so social barriers are easily overcome. Furthermore, the pervasive social influence of the media, reinforces and perpetuates the asexual stereotype in society by narrowly portraying older adults as asexual. Normative physical changes that come with aging, such as menopause and erectile dysfunction, are frequently assumed to lead to asexuality. This is not necessarily true- those that see physical changes as natural adapt their sexual lives accordingly. Psychological factors that effect sexuality in later life are the internalization of societies prescription of what ‘normal’ sex life is for older adults. As a result it is common for older adults to deprioritize sex as a means to conform to ‘norms’ regarding sex later in life.

Sexuality, aging, and dementia

Sexuality in later life and its relationship to dementia is a neglected topic: greater understanding of the area has the potential to contribute to the quality of life of people with dementia, their family members, and formal carers. We review current knowledge about sexuality, aging, and dementia. We undertook a review of the recent literature to examine of the following areas: what is known about sexuality and aging, and about attitudes to sexuality and aging; what is known about the relevance of sexuality and aging to people living with dementia and their care; and the management of sexual behaviors causing concern to others. Sexual activity decreases in frequency with increasing age but many older people remain sexually active; there is no age limit to sexual responsiveness; and sexuality is becoming more important to successive cohorts of older people, including people living with dementia and gay, lesbian, bisexual, and transgendered elderly people. Attitudes and beliefs toward sexuality and aging are strongly influenced by stereotypes and myths, not only among the general public but also among those working in health and social care. Professional bodies should include sexuality, aging, and dementia in their training curricula. More work is needed on the impact of environmental issues, particularly in group living situations, on older adults' sexuality, and on consent issues. Ethical decision-making frameworks can be useful in practice. Organizations should investigate how to support staff in avoiding a problem-orientated approach and focus on providing holistic person-centered care.

Sexual Expression in Later Life: A Review and Synthesis

In the past decade, researchers have begun to study the sexual functioning of typical older persons. This review summarizes literature on the sexuality of men and women over age 50 as researched by social and health scientists. Research on the relationship of biological factors (changes accompanying aging), health (physical, mental, and medication use), psychological factors (attitudes, information about sex), relationship factors (status, satisfaction), and sexual functioning (desire, dysfunctions, treatment) to sexual behavior is reviewed. The review suggests that (a) men and women remain sexually active into their 70s and 80s, (b) aging-related physical changes do not necessarily lead to decline in sexual functioning, and (c) good physical and mental health, positive attitudes toward sex in later life, and access to a healthy partner are associated with continued sexual activity. In turn, regular sexual expression is associated with good physical and mental health. Progress in understanding later life sexuality requires development of comprehensive theoretical models, a broad focus on intimacy, attention to measures and samples, and research on couples. Progress in understanding is especially important, given the aging of populations.

Older Women, Marital Relationships, and Sexuality in China

Based upon field research conducted in China in the 1990s and 2000s, this article examines older Chinese women’s views and practices surrounding sexual interaction in later life. In contrast to local clinical depictions of middle-aged and elderly Chinese women as repressed by feudal superstitions concerning sex in later life, this research shows that more middle-aged and elderly Chinese women are sexually active than such clinical sources assume. Furthermore, there is no neat correspondence between sexual attitudes and sexual activity, and Chinese women’s attitudes concerning later life sex are often much more liberal than their behavior. Absence of sexual activity among older Chinese women is more closely related to problems in the marital relationship in general and/or to health problems than it is to attitudes about age and sex. At the same time, many Chinese women challenge the claims of western sexology that presume the marital relationship and sexual interaction to be a top necessity for a good quality of life in the later years. These findings have important implications for public health education, clinical training, and health and social service delivery in China.

Seeking Medical Help for Sexual Concerns in Mid- and Later Life: A Review of the Literature

Research consistently reports that older people tend not to seek medical help for sexual concerns or difficulties. This article reviews the literature to examine help-seeking for, and doctor–patient interactions about, sexual problems in the middle and later life age groups. Twenty-five articles from 1999 to 2010 were identified and analyzed. Significant barriers to seeking medical help included psychosocial factors relating to the patient, such as thinking that sexual changes were “normal with ageing,” and also to the doctor—for example, assuming that sex was less important to older patients than it was to their younger patients. Inadequate training at medical school for health care professionals (HCPs) was also identified as a barrier. People were more likely to seek help if their doctor had asked about sexual function during a routine visit sometime during the previous three years. However, doctors tended not to take a proactive approach to sexual health management, and indeed often had limited knowledge of later-life sexuality issues. There are clear implications for sexual well-being if the doctor does not ask and the patient does not tell. Providing education about later-life sexuality for HCPs is crucial if we are to meet the needs of older patients in useful and effective ways.

A review and commentary on the factors that influence expressions of sexuality by older people in care homes

The aim of this paper is to review the literature on factors that influence the expression of sexuality by older people in care homes. Sexuality is an intrinsic part of what we are, however there is evidence to suggest that the sexual needs of older people are often overlooked, particularly in long-term care settings. Whilst there is information about sexuality and its expression in later life, questions remain as to how this influences and is influenced by the behaviours and experiences of residents and staff in care homes. A systematic search of online databases. Databases using keyword and bibliographical searches in a specified timeframe were undertaken. Research studies ranging from 1996-2009 were selected for inclusion on the basis that they addressed issues relating to expressions of sexuality by older people in care homes. Forty articles were included in the review. The review revealed a dearth of rigorous research on sexuality amongst older people in general and care home residents in particular. Issues identified in the literature were categorised into four broad thematic areas: sexuality and ageing, expression of sexuality in care homes, attitudes of staff and sexuality in dementia. There is a dearth of rigorous research on the factors influencing sexual expression by care home residents. Attitudes of staff in care homes influence their perceptions about the extent to which the expression of sexuality by residents is considered to be problematic. This, in turn influences the emotional and behavioural responses of staff to the resident. There is need for nurses and other care staff to gain a better understanding of and insight into late life sexuality. This involves change at an educational level but also at an organisational and cultural level in long-term care settings.

HIV, Sexually Transmitted Infections, and Sexuality in Later Life

In this article, we review recent evidence indicating that people over the age of 50years are increasingly at risk of HIV and sexually transmitted infections, and that-thanks to the success of highly active antiretroviral therapies-those infected with HIV are now living into older age. We show that health professionals and society in general have been reluctant to acknowledge sexuality in older adults. Sexuality until recently has been regarded as merely a matter of male potency and sexual function, whereas older women's sexuality and desires have been ignored. Changing patterns of sexual practices, including high rates of divorce and partner change in the older age groups, indicate that focus and concern with sex and sexuality in later life will become part of routine prevention and maintenance of sexual health.

A Drama Project about Older People's Intimacy and Sexuality

This paper describes an intergenerational project developed in partnership between a social work degree program and an Older People's Theatre group. Bringing together a small group of students, older actors, and film makers, methods from drama and the arts were utilised to explore the topic of intimacy and sexuality in later life. The project produced digital stimulus learning materials. Formal evaluation identified beneficial outcomes for participants highlighting the advantages of older people's leadership in social work education and the transformative potential of the dramatic learning methods used. Such pedagogical approaches are essential to achieve genuine quality personalized outcomes for older people in contact with care services.

Science, medicine and virility surveillance: ‘sexy seniors’ in the pharmaceutical imagination

Abstract While historically sex has been seen primarily as the prerogative of the young, more recently, the emphasis has been on the maintenance of active sexuality as a marker of successful ageing. A new cultural consensus appears to have emerged which not only emphasises the importance of continued sexual activity across the lifespan, but links sexual function with overall health and encourages increased self-surveillance of, and medical attention to, late-life sexuality. Drawing on historical accounts, clinical research, popular science reporting and health promotion literatures, I explore several key shifts in models of sexual ageing, culminating in the contemporary model of gender, sexuality and ageing that has made ageing populations a key market for biotechnologies aimed at enhancing sexual function. Two central concepts frame my analysis: 'virility surveillance', where age-related changes in sexual function are taken as indicative of decline, and the 'pharmaceutical imagination', where sexual lifecourses are reconstructed as drug effects revise standards of sexual function. After consideration of how narratives emerging from qualitative research with older adults challenge the narrow depiction of sexual functionality promoted by pharmaculture, conclusions call for continued critical inquiry into the biomedical construction of sex and age.

Från fula gubbar och liderliga gummor till virila casanovor och glada änkor?

Two lines of thoughts have historically characterised the understanding of sexuality in old age in Western society. On the one hand elderly persons sexuality have been portrayed in literature and dramas since the antiquity and onwards. However these images have often been negative, ridiculing sexuality in late life. On the other hand old age has been associated with asexuality – philosophers, and other intellectuals as well as religious authorities have often articulated this position. In addition you may say that the asexual standpoint generally has been positively charged. Nevertheless attitudes towards sexuality in old age began to change in the midst of the 20th century. This is for instance apparent in works from sexology, not the least the Kinsey reports (1948, 1953), but also Masters’ and Johnson’s publications from the 1960s. During the 1960s a book that specifically dealt with old age and sexuality was published, namely Sexuality After Sixty (1965), by the American sexologist Isadore Rubin. In this publication the view on sexuality is particularly positive. Rubin for instance claims that it is vital and good for the health to keep sexually active as long as possible. This statement is supported by Masters and Johnson. Rubin’s and Masters’ and Johnson’s writings are illustrative for their time and may be related to the current social and cultural context of sexual debate, youth culture and young people revolting against authorities and old-fashioned thinking. Youth becomes a norm at this point in history. My interpretations mainly deal with how youth culture, sexuality and gender identity interrelates. Masculinity seems to be strongly associated with heterosexual intercourse, and aging appears to be antithetic to masculinity – the status of the man diminishes as the aging process proceeds. The connotations to femininity also alter, but not in the same sense as with masculinity.

Sexuality in later life: opportunity for reflections for healthcare providers

The theme of sexuality of older adults is rarely addressed by the healthcare professionals. In this brief overview, the authors offer some thoughts in regards to the sexuality of older adults, demonstrate that the sexuality is a lifelong need and illustrate the effect that different societal attitudes have so far on the behavior practiced by seniors in the expression of sexuality and intimacy. The authors provide several exercises to assist healthcare providers in assessing their position on the topic of sexuality in later life.

Factors influencing young adults’ attitudes and knowledge of late-life sexuality among older women

Objectives: Although sexuality is valued throughout the lifespan, older women's sexual expression can be influenced by physical, mental and social factors, including attitudes and stereotypes held by younger generations. By gaining an understanding of what influences negative attitudes toward sexuality and beliefs about sexual consent capacity, the stigma associated with sexuality in late life may be reduced. Method: Using vignette methodology in an online survey, we examined older women's health and young adults’ (N = 606; mean age = 18.86, SD = 1.42, range 17–36) general knowledge and attitudes toward aging and sexuality, personal sexual behavior, religious beliefs and perceived closeness with an older adult on attitudes towards sexual behavior and perceptions of consent capacity among older women. Results: The health status of older women proved important in determining young adults’ acceptance and perception of sexual consent capacity regarding late-life heterosexual/autoerotic and homosexual behaviors. Specifically, young adults expressed lower acceptance and more doubt regarding capacity to consent to sexual expression when the older woman was described as cognitively impaired. Additionally, young adults’ personal attitudes toward late-life sexuality, but not knowledge, predicted acceptance toward sexual expression and belief in sexual consent capacity. Conclusion: Attention toward the influence of older women's cognitive health and young adults’ attitudes toward late-life sexuality may prove beneficial in designing interventions to decrease the stigma associated with sexual activity in later life.

Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001

Objective To study secular trends in self reported sexual behaviour among 70 year olds.Design Cross sectional survey.Settings Four samples representative of the general population in Gothenburg, Sweden.Participants 1506 adults (946...

Sexual Issues in Special Populations: Geriatric Oncology – Sexuality and Older Adults

To provide an overview of sexuality and sexual expression in older adult cancer survivors and to outline implications for nursing and interdisciplinary practice. Research articles, abstracts, reviews, and clinical expertise. Unique features of sexuality in late life provide evidence to support clinical exploration of sexuality for older adult cancer survivors. Approaches to intervention with older adult cancer survivors are predicated on adaptation of best practices in sexuality and sexual health to create care that is sensitive to age and generation. Targeted research in sexuality for older adult cancer survivors includes intimacy, relationship, sexual experience, and imbedded sexual behavior. Nurses can improve the care of older adults with cancer by careful consideration of intimacy and sexuality using standards of practice with younger adults integrated with understanding of issues unique to later life.

Late-Life Sexuality Presents Problems, Rewards

Late-Life Sexuality Presents Problems, Rewards