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The Voice of Nursing Education

Sexuality and the Older Adult


Sexuality is at the core of who we are and has an impact on our lives in so many ways. It does not stop once we hit the age of 60 or 70 or 90 or even 100 despite the myths and assumptions of society. Sexual desire does not necessarily dissipate with age, but the physical, cognitive, and psychosocial changes that can occur with aging may interfere with sexual outcomes. Issues of sexuality with older adults often become a taboo topic; whether it is the expression of desire or the inappropriate sexual acting out of the individual with dis-inhibition secondary to dementia. 

In the long-term care environment, expressions of sexuality are frequently labeled as problem behaviors.  The number of older adults testing HIV positive is on the rise thereby making safe sex practices a priority topic of discussion for health care professionals. Clearly sexual issues are fairly common among older adults, but the health care team infrequently addresses these issues. Student nurses are no different. They frequently report a level of discomfort with initiating discussions of sexual assessment with their patients in general but more so with their patients who are older adults. There are sexuality assessments that are often a sub-section of general assessments, but are often glazed over secondary to the discomfort of the examiner or the hypothesis that it is not of importance to the examiner.  Common sexual side effects of medications such as antidepressants are regularly discussed with younger patients but very rarely addressed with older adult patients. 

The need to raise a student’s awareness of the complex issues surrounding sexuality of older adults is a focus of this teaching strategy. In addition, this teaching strategy is designed to increase the comfort level of the student and to routinely include an integration of sexuality assessment in the plan of care of older adults. The landmark Masters and Johnson study (1986) links increased quality of life with the fulfillment of sexual desire. Empowering nurses to advocate for the sexual needs of their older adult patients and to look at sexuality in the context of functionality may start to break down the taboos seen as a barrier to optimal quality of life for this population. This teaching strategy can be used for the pre-licensure nursing student or to address the complexity of the issue for current nurses achieving further degrees.

Sexuality and the Older Adult

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