Addressing Issues of Sexuality with Older Couples

By Skultety, Karyn M. | Generations, Fall 2007 | Go to article overview

Addressing Issues of Sexuality with Older Couples


Skultety, Karyn M., Generations


How can healthcare and social service providers encourage discussions of this vital aspect of older adults' relationships?

One need look no further than Amazon, com to learn that sexuality is a vital part of older adults' relationships. A simple search on sex and aging returns over 1,000 books, including these recent tides: Better Than I Ever Expected: Straight Talk About Sex After Sixty (Price, 2006), Our Bodies, Ourselves: Menopause (Boston Women's Health Book Collective, 2006), andDr. Ruth's Sex After so: Revving Up the Romance, Passion, and Excitement! (Wesdieimer, 2005). It should be no surprise to professionals who work with older people that sexuality in later life is gaining public interest, given that research dating back to the 1980s (e.g., Bretschneider and McCoy, 1988) demonstrated the importance of sex to older adults. Yet, despite diis evidence and much written by clinicians on this topic (e.g., Burgess, 2004; Hillman, 2000), the literature in this area has been slow to expand. In addition, healthcare providers, even those with vast geriatric experience, continue to report their own discomfort and lack of knowledge regarding older adults' sexuality (Bouman and Arcelus, 2001; Sadovsky et al., 2006). Thus, the question remains, how do we begin to make sexuality a regular part of our work with older couples?

A valuable review published by Zeiss and KaslGodley (2001) summarized the available literature on sexuality and aging. Throughout the article, the authors noted several limitations in the literature, including a reliance on cross-sectional studies in documenting the relationship between sexual activity and aging, poor definitions of sex, and samples consisting only of heterosexual, Caucasian, well-educated, and healthy older adults. The authors concluded that while knowledge is increasing in this area, much work remains. The purpose of this article is twofold. The first is to return to the issues raised in the Zeiss and Kasl-Godley (2001) review and highlight recent additions and advances in the literature. The second purpose is to discuss how to translate the latest research to information that can guide professionals and help them address sexuality with older couples.

Throughout this article, I have tried to address issues relevant to a wide range of couples. However, the article does not address the unique concerns of homosexual, bisexual, or transgendered couples. I highly encourage readers to review de Vries's article (this issue) on this important topic. In addition, I have not provided a review of the normal age-related changes in sexual functioning. It is important to remember that these changes (i.e., slowed sexual response time, decrease in orgasmic intensity, longer refractory periods) do not explain older adults' ceasing sexual activity or loss of sexual desire. Practitioners should assume that older couples can adapt to normal age-related changes and maintain satisfying sexual relationships (George and Weiler, 1981). A complete discussion of normal aging and sexuality is available as part of the American Public Health Association's resources on aging and sexuality (http://www.apa.ofg/pi/aging/sexuality.htnd) and in past reviews (Zeiss and Kasl-Godley, 2001; Salzman, 2006).

SEXUAL DESIRE AND ACTIVITY

With findings similar to those of the recent past (Zeiss and Kasl-Godley, 2001), many researchers continue to suggest that sexual activity and desire decline with age based on findings from cross-sectional studies (e.g., aarp, 2005). While cross-sectional studies have consistendy shown that the current group of older adults engage in less sexual activity than the current group of younger adults, it is unknown if these differences are related directly to aging, to cohort differences, or to time of measurement. Early longitudinal studies on aging and sexuality found that the majority of older adults maintain a steady interest in sexual activity throughout the lifespan (Bretschneider and McCoy, 1988). …

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