Sexuality In Later Life Research Articles

Learning about sex in later life: sources of education and older Australian adults

This paper examines the preferred sexuality education sources of older Australian adults in later life. Drawing on findings from qualitative interviews with 30 men and 23 women aged 60 years and older, we consider the sources that participants currently use, or would like to use, in seeking information about sex. Where relevant, we examine participants’ experiences of learning about sex in later life using different sources, and the impact these had on their sexual expression, pleasure and well-being. Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices. As such, learning about sex should be viewed as a lifelong endeavour. Our findings carry important implications for the development and delivery of sexuality education for older adults.

Physicians' response to sexual dysfunction presented by a younger vs. An older adult

The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction presented by older vs. younger patients in terms of attributed diagnosis, etiology, proposed treatment and perceived prognosis. An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by the age of the patient (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an "old" vignette and 126 physicians received a "young" vignette. Even though both cases presented with a clear psychosocial etiology, the "older" vignette was more likely to be diagnosed with erectile dysfunction whereas the "younger" vignette was more likely to be diagnosed with performance anxiety. The "older" vignette's dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend testosterone replacement therapy (TRT) and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) as well as a referral to urology to the "older" vignette. In contrast, the "younger" vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the tendency to prescribe PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette. Copyright © 2016 John Wiley & Sons, Ltd.

Older Women in New Romantic Relationships.

Although research has found that sexual activity declines with age, most of this literature examines people in long-term marriages. Little is known about the initiation of new sexual relationships in later life. In-depth interviews with 14 women aged 64 to 77 years were conducted to examine their personal and collective narratives regarding sexuality in later life. In contrast to common perceptions, none of the participants felt that aging had negatively impacted their own sexuality. For many, this was a time in their lives when they were experiencing renewed sexual desire and enjoyment. Even though sex might not have held the same priority as when they were younger, it held a place of importance in their romantic relationships. The discussion focuses on understanding women's sexual relationships and behaviors within the context of their cohort and lives.

Nurses' knowledge and attitudes toward aged sexuality in Flemish nursing homes.

Admission to a nursing home does not necessarily diminish an older person's desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents. To investigate nursing staff's knowledge and attitudes toward aged sexuality, to determine whether certain sociodemographic factors of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes. Descriptive cross-sectional survey study. The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated. The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven. Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life. Research findings are discussed within a broader international context. There is room for improvement for both nursing staff's knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups of nursing home staff for these interventions.

Sexual well-being of older men and women

Most older adults experience sexual desire and engage in sexual activity, however, our knowledge about the sexual well-being (SWB) of older adults is still scarce. The present study aimed to examine the SWB of older adults as well as differences in their SWB based on gender and relationship status. The final sample consisted of 297 adults (149 men and 148 women) who ranged in age from 65 to 75 years; 63% (n=188) were currently in a romantic relationship. Participants were recruited using the crowdsourcing platform Amazon's M-Turk. Participants completed a background questionnaire, as well as measures of sexual behaviours (frequency of genital and non-genital activity and masturbation alone), sexual affect and cognitions (sexual esteem, attitudes, and satisfaction), sexual motivation (sexual interest), and sexual functioning. Our participants reported overall positive SWB; specifically, positive sexual self-esteem and attitudes toward sex as well as high sexual satisfaction and interest. Furthermore, participants who were in a relationship engaged in frequent genital and non-genital sexual activity. About two-thirds of the participants in a current relationship had experienced at least one sexual difficulty in the last three months, but only one-quarter were distressed about it. Although some gender and relationship status differences emerged, in general both the men and women and participants who were and were not in a relationship reported positive SWB. These results are discussed in terms of the ways in which they extend our knowledge on the SWB of older adults and challenge popular myths about sexuality in later life.

Sexuality & dementia: An eLearning resource to improve knowledge and attitudes of aged-care staff

ABSTRACTExpression of sexuality by older people, particularly those with dementia, can be challenging and confronting for aged-care staff. Education on this topic is often a low priority area for aged-care organizations, and there appears to be limited training programs available. Results from our study highlighted the value of an eLearning education intervention that significantly increased aged-care staff and nursing students’ level of knowledge relating to older people’s sexuality. It also improved their attitudes and permissiveness towards late life sexuality and the expression of sexuality by people with dementia. Furthermore, respondents reported the importance of existing workplace policy (if any) on the expression of sexuality, the overall signs of wellbeing and ill-being exhibited by people with dementia, and the need for guided discussions with family members. Significant improvements in staff understanding and response towards the expression of sexuality by people with dementia may enable the facilitation of a care environment that is supportive of the verbalization and expression of sexual preference, need, and desire by people with dementia. This can, in turn, improve quality of life, health, and wellbeing for people with dementia as well as reduce potential tensions between staff-resident-family when sexual expression is considered to be inappropriate.

PDE5i as a Cure for Older Adults: An Indicator of Ageist Practices among Physicians

Objective: The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction in older vs. younger patients in terms of diagnosis, attributed etiology, proposed treatment and perceived prognosis. Design and Method: An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by age (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an old patient vignette and 126 physicians received a young patient vignette. Results: Even though both cases presented with a clear psychosocial etiology, the young patient vignette was more likely to be diagnosed with performance anxiety, whereas the old patient vignette with erectile dysfunction. The old patient vignette dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend hormonal and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) treatment as well as urology referral to the old patient vignette. The young patient vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. Conclusions: This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the increased prescription of PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette.

Poster Number: EI 8 - Have We Addressed Sexuality in Older Patients Appropriately as Healthcare Providers? Understanding Changes in Later-Life Sexuality and Using Psychosexual Models to Assess Problems

Poster Number: EI 8 - Have We Addressed Sexuality in Older Patients Appropriately as Healthcare Providers? Understanding Changes in Later-Life Sexuality and Using Psychosexual Models to Assess Problems

Sexual Behavior and Concerns in a Sample of Elderly, Former Indentured Swiss Child Laborers.

IntroductionPast research suggests a link between post‐traumatic stress disorder (PTSD) and an increased risk for sexual problems. However, there is still no clear picture whether these higher rates are related to trauma exposure or to PTSD itself.AimThe aim of the present study was to complement existing knowledge on the relative impact of trauma and PTSD on sexuality in later life, considering different aspects of trauma exposure on both men and women.MethodsThe study was conducted on a unique population sample of former Swiss indentured child laborers (55 men, M age 78, age range 60–95 years) who have repeatedly experienced a variety of severe childhood traumas.Main Outcome MeasuresSexual outcomes were measured using two scales from the Trauma Symptom Inventory—Dysfunctional Sexual Behavior (DSB) and Sexual Concerns (SC). PTSD symptoms and trauma were assessed with the Short Screening Scale for PTSD and the Composite International Diagnostic Interview, respectively.ResultsTwenty‐two individuals showed PTSD symptoms, and 53 reported having experienced childhood trauma. Significant differences between men and women were reported for DSB and SC. Men reported a significantly higher prevalence of both SC and DSB compared with women.ConclusionsThis is the very first study investigating DSB and SC in a sample of older adults exposed to similar traumatic experiences and settings. However, some study limitations need to be considered such as the small sample size. Additional studies are needed to further explore the relative role of traumatization and PTSD on sexual behavior and well‐being, especially to improve sexual therapy for patients who experience trauma. Rechsteiner K, Burri A, and Maercker A. Sexual behavior and concerns in a sample of elderly, former indentured Swiss child laborers. Sex Med 2015;3:305–314.

Sexuality in the elderly: The role of the physicians in maintaining sexual health of older men

Sexuality in the elderly is still a social taboo. A commitment by medical practices to address the topic of sexuality in later life is essential, given that the sexual health is part of the quality of life. Identification of barriers and discourse of effects in the physician's behavior when dealing with the sexuality of older people. Review and discussion of interdisciplinary literature and social discourse. Compilation of expert opinions. Although the introduction of phosphodiesterase 5 inhibitors led to a removal of taboos concerning erectile dysfunction, the sexuality of older men became narrowed to physiological aspects. The elderly still complain that consultations concerning their sexuality receives too little attention in medical practice. Problems are boundaries of shame and disregard of the sexuality of elderly. Sexuality in old age will have to become more prominent in medical practices, due to demographic changes and changing self-images of the elderly. The social role of physicians enables straightforward discussions about sexuality. Taking a sexual history and choosing an active approach proved to be practicable to discuss sexual problems with older people.

In Lust We Trust? Masculinity and Sexual Desire in Later Life

Recent years have seen increasing discussions of sexuality in later life. Today, continued sexual activity is gradually understood as a positive and healthy aspect of aging, in contrast to how aging historically was primarily associated with asexuality. Old men’s sexual function, in particular, has been a topic of notable interest to scholars and popular media alike, an interest spurred not least by the market introduction of Viagra and other sexuo-pharmaceuticals. If aging men’s sexual function has been the object of extensive discussion, considerably less attention has been given to the question of sexual desire in later life, neither women’s nor men’s. Old men’s sexual desire is a potentially conflictual field as men are often expected to be sexually willing but the old man who shows continued sexual interest also run the risk of being labeled a “dirty old man.” This article focuses on old men, masculinity, and sexual desire through the interview narratives of Swedish med between sixty-seven and eighty-seven years old. In dialogue with Sara Ahmed’s work on queer phenomenology, the article discusses asserted sexual desire as a form of orientation that shapes old men’s heterosexual subjectivities. The interviewees expressed that sexual desire continued to be an important aspect of later life, but sexual desire was also understood to vanish as one aged. For those who expressed a lack of sexual desire, this was sometimes experienced as a “gender trouble” but was also made sense of in relation to feeling old. All on all, intimacy was a central way of making sense of later life sexuality. The article concludes that narratives on intimacy could be understood as ways of retaining a heterosexual orientation as one ages. Through narratives of intimacy men could express a continued interest in sexuality, but in positive and unthreatening ways that avoided the stigmatization of being a dirty old man.

Incontinence and sexuality in later life.

This article explores the interrelated aspects of incontinence and sexuality in older age. It describes the physiological changes that may have an effect on sexual function and the genitourinary system as people age. The enduring importance of sexual intimacy is discussed. Treatments for incontinence and to improve sexual function are explored. The authors conclude that nurses, particularly those involved in continence management, have a role in ensuring sensitive assessment and access to treatment, which can support many older people to maintain fulfilling sexual activity.

P192 Suddenly you’re on your own, and you’re out there in the big world: middle-aged adults’ sexual risk-taking behaviours within the context of life-course transitions

<h3>Background/introduction</h3> While sexual activity, including partner change, is known to continue throughout the life course, there is a paucity of qualitative evidence on how adults over 45 years engage with risk for sexually transmitted infections (STIs), limiting the scope for effective health promotion among this age group. <h3>Aims/objectives</h3> The research aimed to explore older adults’ sexual risk-taking behaviour within the context of sexuality in later life. <h3>Methods</h3> A qualitative in-depth study involving 31 interviews with middle aged heterosexual men and women aged 45 to 65, recruited from sexual health clinic and community settings. <h3>Results</h3> Vulnerability to STI risk emerged around key life course transitions, including following divorce, separation and bereavement. Some spoke enthusiastically of embracing sexual freedom and pleasure within a perceived changed culture, resulting in frequent partner change; however, many found themselves ‘re-engaging’ with their sexual careers within an unfamiliar gendered landscape. Lacking an (ageing) body confidence led to the prioritisation of intimacy over STI risk; condoms were viewed as being for birth control and therefore mostly unnecessary, or linked with casual sex and lack of trust. STIs were commonly considered to be a young person’s concern. <h3>Discussion/conclusions</h3> Information provision alone will not be enough to counter the complexities of navigating the dramatically different sexual landscape these older adults find themselves within compared to their youth, particularly those who have emerged from long-term relationships. A separately focussed approach to STI prevention taking account of life course experience, ageing and cultural change is advocated.

Sex and the (older) single girl: Experiences of sex and dating in later life

This study explored the sexual subjectivities of older Australian women. In this article we present findings from 15 qualitative interviews with Australian women aged 55-81 who were single at the time of interview. The majority of these women were single following divorce or separation, with a smaller number of women who were widowed or never in a long-term relationship. We found that these women’s sexual desire and sexual activity were fluid and diverse across their life course. Although some participants desired a romantic or sexual relationship, they were also protective of their independence and reluctant to re-enter into a relationship in later life. Our findings indicate that these women’s sexual subjectivities were shaped by dominant norms of ageing, sex, and gender. At the same time, older women are challenging and resisting these norms, and beginning to renegotiate sexuality in later life.

Increasing our Understanding of Women’s Sexuality

I have been reading and writing about sexuality in later life for the past 15 years (Wade and DeLamater, 2002: DeLamater and Koepsel 2015). A growing number of papers reporting results from large-scale surveys in the U. S. have appeared since 1999 (AARP 1999; Lindau, et al. 2007; Herbenick, et al. 2010). These papers systematically report results by gender (binary), sometimes highlighting similarities, sometimes differences. Such reports often leave me wondering Bwhat do these results mean?^ What are the psychological, emotional, and relationship realities that underlie, for example, the difference in sexual satisfaction reported by married men and women? If similar questions interest you, read this book. Montemurro addresses a basic question about female sexuality: how dowomen develop a sense of sexual subjectivity, a sense of Bpossessing agency in sexual interactions,^ Bbeing a willing and eager participant in sexual encounters,^ and Bfeeling in control of sexual decision making^ (p. 4). This question has been addressed by several researchers in studies of adolescent women, including Martin (1996), Tolman (2002), and Schalet (2011); Montemurro expands the focus to adult women ages 20 to 68. She posits that this development occurs over time, perhaps a lifetime; hence the subtitle Bsexual evolution.^ She understands that whether a woman has a sense of her subjectivity can be influenced by a variety of events and transitions that may occur in women’s lives – the circumstances surrounding virginity loss, sexual assault, marriage, pregnancy and childbirth, divorce, menopause, extra dyadic relationships. She adopts the life-course perspective to provide a framework that encompasses this diversity, specifically the Gendered Sexuality over the Life Course (GSLC) model (Carpenter and DeLamater 2012). To study the impact of these transitions across the life course, Montemurro purposively sampled an equal number of women from the northeastern U.S. in their 20s, 30s, 40s, 50s, and 60s. She began recruiting by asking women she knew to recommend women of appropriate age; interviewees were asked to recommend other women. She also recruited by posting notices in a variety of settings. She focused on heterosexual women. Participants were diverse in race/ethnicity, self-reported SES, education, and marital and parental status. An Appendix provides detailed information on each of the 95 participants. In-depth face-to-face interviews, averaging one and one-half hours, were conducted with each one. An important, original contribution of the book is the sixstage model of the development of sexual subjectivity that Montemurro presents. The model is based on her careful analysis of the life experiences reported by participants. The stages are:

"Don't Think Paralysis Takes Away Your Womanhood": Sexual Intimacy After Spinal Cord Injury.

Sexuality and intimacy are important components of health and well-being. Issues surrounding sexuality and intimacy are equally important for men and women living with physical disabilities, including spinal cord injury (SCI). Yet, women's sexuality after SCI remains largely unexamined. This article presents the findings from an in-depth qualitative investigation of the sexual and reproductive health experiences of 20 women with SCI in or around Detroit, MI. Findings echo existing literature documenting the sexual consequences of life after SCI and suggest new areas of inquiry important for better addressing sexual concerns across the lifespan. Specifically, findings suggest a need to consider the variable effects of SCI on sexual intimacy in relation to a person's developmental trajectory, the appropriate timing of sexual education, the need to expand conceptualizations of sexual intimacy, and the ways SCI may affect sexuality in later life.

Constructions of sexuality in later life: Analyses of Canadian magazine and newspaper portrayals of online dating

Advertisements as well as contemporary literature and films often depict older adults as sexually undesirable and unattractive, which reinforces the stereotype that they are nonsexual. However, the evolving discourses of successful aging emphasize that active engagement in life is a key element of healthy aging and as such, have been influencing the ways that older adults' sexuality is represented. This paper explores how popular newspapers and magazines in Canada construct and portray later life sexuality within the context of online dating. We retrieved 144 newspaper and magazine articles about later life online dating that were published between 2009 and 2011. Our thematic and discursive analyses of the articles generated six themes. Of 144 articles, 13% idealized sexuality (sexual attractiveness and optimal sexual engagement) for older adults. The articles portrayed sexual interests and functioning as declining in later life (19%) more often than sustaining (15%). Approximately 15% of the articles suggested that older adults should explore new techniques to boost sexual pleasure, thereby medicalizing and ameliorating sexual decline. In addition, the articles challenged the stereotype of older adults as non-sexual and claimed that sexual engagement in later life was valuable as it contributed to successful aging. We address the paradox in the articles' positive portrayals of older adults' sexuality and the tensions that arise between the two distinct ideals of sexuality that they advance.

Social Representations, Vulnerability And Religious Beliefs Of The Elderly About Hiv/Aids: An Integrative Review

Introduction: sexuality in later life needs to be discussed because of the significant increase of the HIV/AIDS virus in this population segment. Objective: recognizing what has been published about the social representations, vulnerability and religious beliefs of older people about HIV/AIDS. Method: an integrative review study of literature inserted into the virtual portals: LILACS, MEDLINE, SciELO and BDENF. There were used as descriptors: vulnerability, HIV, elder, religion. The data collection instrument included: article title, objective, level of evidence, year, country, publishing journal, methodological approach of the study, data collection technique and the main results. There were met 242 published titles, and 17 articles were about the purpose and were distributed among national and international journals. Results: the social representations about HIV/AIDS were linked to cultural issues, educational, behavioral, religious. The reasons for vulnerability to the virus were multifactorial. Religious beliefs influenced the construction of social representations and perception of forms of vulnerability to HIV/AIDS. Conclusion: it needs to change some existing concepts among seniors about social representations, vulnerability and beliefs of HIV/AIDS.

An exploratory study on sex in later life from a gender perspective

An exploratory study on sex in later life from a gender perspective

The Sexuality Experience of Older Widows in Korea

Sexuality plays an important role in elders' lives. However, few studies exist concerning the essential meaning crucial for the overall understanding of sexuality in later life. In this study we explored the experience of what sexuality implied and meant to older widows using the descriptive phenomenological approach. Purposive sampling yielded 10 elderly women who were in sexual relationships. We collected data through in-depth interviews with participants and conducted a thematic analysis. The findings were classified into eight themes: trying to find another side of herself, starting a romantic relationship, invigorating life, displaying femininity, being concerned about the perceptions of others, enjoying sexual freedom, feeling the limit of sexual intimacy, and facing up to reality. The sexual lives of older widows entailed a process of recovering their femininity, self-achievement, and self-esteem, which helped them to live independent lives by developing more active and flexible attitudes.