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Saturday, March 7, 2009

Sexuality of older adults needs recognition

“Age should never be a limiting factor in sexuality and intimacy.”

That remark summarizes the thoughts of Dr. Nathalie Gamache, a gynecologist at the Shirley E. Greenberg Women’s Health Centre of the Ottawa Hospital, who recently gave a presentation to the Council of Aging of Ottawa.

While Geenberg focused on women, Carmen Rodrigue, a nurse with Geriatric Psychiatry Community Services of Ottawa, addressed the issue for both sexes.

“We are all sexual human beings,” said Rodrigue, while noting we do not all express our sexuality in the same manner.

Our sexual expression is influenced by our values, beliefs, and culture. Other factors in sexual expression include hormonal levels, general health, including mental health, and satisfaction with your partner (if you have one).

Drugs have an impact, with anti-depressants, for example, decreasing libido. Alcohol also has an effect. In addition, confidence, self-esteem, stress, and tiredness come into play. Expectations and willingness to experiment are determinants of sexual expression.

As men become older, it takes longer and requires more stimulation for them to become aroused. An erection is less firm and of shorter duration than in youth. However, erectile dysfunction is not simply caused by aging. It is a condition that should be discussed with a doctor.

Like men, older women require more stimulation for arousal. Desire may decrease, and there is decreased sensitivity of clitoris and breasts. One problem can be vaginal dryness, for which a water-based lubricant should be used. Ask the doctor or pharmacist about a suitable product.

It is important to practice safe sex. Sexually transmitted diseases can strike at any age. A condom is strongly recommended if you are not sure of the sexual health of your partner. However, sexuality is not simply a matter of sexual intercourse. It can include touching, cuddling, closeness, tenderness, warmth, emotional support, affection, and companionship as well.

Family attitudes toward seniors’ sexuality can be an issue. Children and other family members may be bearers of ageism and may be over-protective and controlling. As well, they may be concerned about the possibility of losing an inheritance.

Seniors need to be assertive and exercise self-esteem in resisting intrusions in personal choices and new relationships. The older person needs to be in control and to experience belonging and love.

Even in dementia, libido continues in most cases. Other sexual needs such as closeness and tenderness continue. Because insight and judgment are impaired, a demented person can become too disinhibited, and the past may be seen as the present. Thus, a man who experiences personal care from a nurse may interpret the attention as affection, and sexual advances will need to be discouraged.

When a person with some dementia is sexually active, the person needs to be aware of what is happening, avoid being exploited, and recognize risks, such as the fact that a relationship may end.

Gamache pointed out that this is the first time in the history of Western society that women’s desire for sexual satisfaction is considered legitimate.


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