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Population Health Spring 2018 Population Health Vol Jefferson College of Population Health Spring 2018 Population Health Vol. 31, No. 1 Matters Optimizing Older Adult Sexual Expression Sex is Alive and Well talk about Eddy today?” My response: “Sure, Sexuality is a central aspect of being human Most people are uncomfortable when tell me more about Eddy.” Older adult: and encompasses sex, gender identity and confronted with issues relating to older “Eddy is my vibrator.” roles, sexual orientation, pleasure, intimacy adult sexuality. In my experience as a trainer and sexual health; and it is influenced by and sexuality educator for close to 25 years, A man in his 80s talked about how making social, economic, political, cultural and I have talked about sex with people of all love to his wife (now deceased) was “the religious factors. We express our sexuality ages: young girls and their parents (mostly best sex he ever had, and I still think about in our thoughts, fantasies, desires, attitudes, their moms) about what to expect in those years.” Another person asked whether values, and behaviors, and these change puberty, high school and college students or not oral sex was still “sex” and if it was throughout our lives. navigating their way through mating and “safe”. A woman shared, “It’s been so good dating, adults who were incarcerated and/ to talk about sex and relationships. I haven’t Implications for Practice or in recovery, and older adults and their talked about it to anyone in years, these Sexual expression and intimacy among service providers. Human sexuality is a conversations bring back such pleasant older adults is a reality that providers who compelling topic, and the curiosity and memories.” A 70+ year old transwoman work with them must be prepared to enthusiasm it arouses is perfectly normal talked about her gender transition process face. How can we help them to meet this regardless of the age group. that started in her mid 50’s and how challenge and support healthy older adults’ much happier she is. Grandparents asked sexual expression across the decades of However, for many, fascination with the questions about their grandchildren’s “gay aging? Here are some tips: subject of human sexuality is also charged identity” and if the word “queer” was okay with negative emotions and concerns. to use. Older LGBT adults voiced concerns • Remember that sexuality is physical, Sometimes curiosity is tinged with feelings and fear about “coming out” when seeking mental, emotional, and spiritual and spans of guilt, shame, fear, and foreboding; and aging services. an individual’s entire life. The need to often for good reason. Sexuality issues enjoy and express one’s sexuality does not include topics that are very difficult to So many people, even those who work in diminish with age. Older adulthood can discuss and this can be especially true the field of public health, may not think be a time of new discoveries and powerful when we talk about older adults. of seniors experiencing intimacy and sexual experiences. Being “sexually active” sexuality concerns. The above anecdotes involves more than just intercourse. Sex and sexuality are human needs that reflect some of the needs seniors have evolve and change over the lifecycle in relation to their sexuality and sexual • Understand your beliefs and attitudes and the need for intimacy is ageless. It is activities; concerns about relationships, toward sexuality in later life, and examine simply not true that people lose interest in feelings, memories, morality, and the lack any barriers there might be to working sex as they age, regardless of their sexual of knowledge. supportively with older adults. The Aging orientation and gender identity or the Sexual Knowledge and Attitudes Scale health challenges they may face. Sex and Sexuality: Is there (ASKAS) is a tool designed to measure a difference? two realms of sexuality as they relate to The following anecdotes exemplify some of There are many facets of senior sex and older adults: knowledge about changes the ways sexuality evolves and changes as sexuality, but too often, the words sex and in sexual response and general attitudes we age, but is still very much a part of who sexuality are used interchangeably, and about sexual activity.1 we are. that may lead to diminishing the value of sexuality as we age. • Get to know the important sexuality Consider the following question asked by and intimacy issues that are specific a member during a recent workshop on One can think of sex in terms of intimate to those served—older adults living “SEXcessful Aging” that I conducted at a behaviors people engage in, or what box to with HIV, residents in long-term care local senior center: “Will I have a chance to check when identifying one’s gender. setting, lesbian, gay, bisexual and/or CONTINUED ON PAGE 2 Jefferson College of Population Health Spring 2018 Population Health Vol. 31, No. 1 Matters transgender older adults, clients with Intensive Therapy, a model developed towards sexuality, intimacy and relationships, dementia. Increasing understanding will by psychologist Jack Annon to address which are key to successful aging and help providers become more aware of and sexuality issues with patients.1 The quality of life. identify intimacy needs and opportunities PLISSIT model provides a framework for for discussion, as well as offer tools to conversations about sexuality, including begin addressing intimacy needs. sexual health. The model includes several Terri Clark, MPH suggestions for initiating and maintaining Prevention Services Coordinator • Advocate that sexuality and intimacy be the discussion of sexuality. Action Wellness integrated into the services provided. For [email protected] example, education for staff, addressing To summarize, sexuality is an important sexual consent policies, activities that allow contributing factor to quality of life and Terri is a certified trainer with the SAGE seniors to build intimacy/relationships wellbeing. Sexuality, intimacy, and sex are (Services and Advocacy for GLBT Elders) (dances, date nights, social functions), central pleasures to the human experience serves on the American Society on Aging’s incorporate physical intimacy goals into and all adults have the right to express Leadership Council of their LGBT Aging physical therapy, or provide a confidential their sexuality, regardless of their age, Issues Network (LAIN) constituent group and space for older adults to discuss sexual sexual orientation, gender identity or HIV is currently the Coordinator of Prevention health issues. status. We all need to join in conversations Services at Action Wellness in Philadelphia, PA. with older adults to empower them with To learn more about Terri and Action Wellness • Learn about the PLISSIT model. PLISSIT comprehensive information about sex and visit: https://www.actionwellness.org/ is an acronym for Permission, Limited sexuality, thereby increasing knowledge and Information, Specific Suggestions, and developing positive attitudes and behaviors REFERENCES 1. White CB. A scale for the assessment of attitudes and knowledge regarding sexuality in the aged. Archives of Sexual Behavior. 1982 December; 11(6):491-502. 2. Annon, JS. Behavioral Treatment of Sexual Problems: Brief Therapy. Oxford, England: Harper & Row; 1976. 2.
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