AGING AND ITS EFFECTS

Aging and Its Effects on Intimacy, Relationships and Sexuality: A Social Context



Aging and Its Effects on Intimacy, Relationships and Sexuality: A Social Context

Introduction

Doctors can help older patients improve the quality of their lives by learning more about sexuality, intimacy and aging. The United states is getting older. The elderly population is growing faster than any other age group. Between 1980 and 1991, the total population increased 11%. At the same time, the 85-and-over age group grew by 41%, to 3.2 million people, and the 75- to 84-year-old age group climbed 33% to 10.3 million people, according to the National Center for Health Statistics. As a result, physicians will be seeing significantly more older adults in their practices (Edna and Cornelia, 2002).

Tending to their health needs will involve more than treating chronic, debilitating conditions associated with aging. As people live longer, healthier and more active lives, physicians will also need to address concerns about sexual health. Despite trends in aging, few interventions are being carried out by health care professionals to facilitate older adults' expression of sexuality, said Meredith Wallace, RN, a geriatric nurse who writes about sexuality, intimacy and older adults.

That's partly because many primary care physicians lack training in sexuality, said Joanne Schwartzberg, MD, director of the AMA's Dept. of Geriatric Health. Doctors often don't feel comfortable raising sexual issues with their elderly patients and many fall to routinely ask older adults about their sexual concerns and behavior. Consequently, older patients often lack adequate information, even about such basics as the physiological changes that accompany aging and the effects of medications and various health conditions on sexual desire and performance, Dr. Schwartzberg said.

"Older adults need to be informed about these changes and how to compensate for them to function sexually," said Wallace. The AMA's Dept. of Women's and Minority Health is developing a training curriculum for physicians on how to communicate with patients about sexual issues and incorporate discussions about sexuality into daily practice. Part of the curriculum, which will be available to state medical societies in the fall for use in society-run workshops, specifically addresses concerns of the elderly (Edna and Cornelia, 2002).

"Discussion about lifestyle changes should be a part of the counseling that's offered as a clinical preventive service," Dr. Schwartzberg said. In fact, receiving information in itself can be therapeutic for patients because it increases their sense of control and can enhance emotional well-being, said Wallace. A starting point for physicians is understanding the myths about sexuality and old age that can get in the way of patient education. Following are some of the most common misconceptions:

1 Old People Aren't Interested In Sex

"People stay sexual until the day they die," said sexologist Domeena C. Renshaw, MD, professor of psychiatry at Loyola University Medical School in Chicago, and director of the Loyola Sexual Dysfunction Clinic. "Patients are not abnormal when they ask for sexual help at later ages."

Case in point: A 65-year-old man and his 61-year-old wife recently sought help at the Loyola clinic ...