CH 31: Sexuality and Intimacy Flashcards
attitudes towards sex and older adults
Discussion and education were discouraged and avoided with this generation
Any signs of interest in sex or open discussion of sex by older persons is mocked, discouraged, or viewed suspiciously
Misconceptions reinforce fears and aversions of getting older, impose conformity on older adults, and safe sex practices are ignored
Recognize and respect the sexual identify of any individual regardless of age
Over one in six adults over 50 account for the HIV population
–May not use a condom b/c of less risk of pregnancy and belief that only younger people get STIs, embarrassed to seek medical attention
–Reinforce safe sex practices and sex counseling
sexual behavior and roles in older adults
Older adults do enjoy foreplay and intercourse
Homosexuality, masturbation, and multiple sex partners continue in old age
There is diversity in the sex role identify in the older adults
Intimacy
intimacy in older adults
Includes love, warmth, caring, and sharing between individuals
Feeling important and wanted by another person _ security, comfort, and emotional well-being
age related changes and sexual responses in older adults
Decrease in sexual responsiveness
Reduction in frequency of orgasms
Less vaginal secretions
Older men are slower to erect, mount, and ejaculate
Dyspareunia
Older women gain new interest in sex
Regular sexual expression for both sexes is important to maintain sexual function
Permanent cessation of menses for one year due to hormonal changes; occurs in 50s
menopause
menopause marks entry into:
Marks entry into a new season of life with wisdom, groundedness, wholeness of mind, body, and spirit
self-acceptance
treatment fo menopause
Hormone therapy: should be individualized, is most effective for vasomotor symptoms; prevents bone loss and fracture
Acupuncture, meditation, exercise, guided imagery, stress management, Tai Chi, vitamins, yoga, vaginal moisturizing agents, increased foods with estrogen (carrots, apples, beans, celery, nuts, seeds, soy; asparagus, broccoli, cabbage, peaches, tomatoes, prunes, strawberries)
favorable risk-benefit for treatment of older women with menopause
Favorable risk-benefit for women <60 within 10 years of menopause
Less favorable risk-benefit for women >60 who initiate therapy more than 10-20 years from menopause
Increase risk for blood clots, stroke, and coronary artery disease
what is andropause
Men experience decline in testosterone
Doesn’t occur in all men
andropause can cause:
reduced muscle mass, energy, strength, and stamina
erectile dysfunction
breast enlargement
osteopenia
osteoporosis
shrinkage of testes
reduced libido
andropause has a higher risk in:
type 2 diabetes
CKD
tx of andropause
Androgen replacement therapy
–Not recommended for issues with prostate (can enlarge)
barriers to sexual activity
Unavailability of a partner
–Lack of a partner from spousal death, disability, or institutionalization
Ageism & misconceptions
–Reluctance to express sexually and negative attitudes from society
–Provide straightforward explanations and educate about the realities and importance of sexual function
Changes in body image
–Reluctance to view oneself as sexually attractive
–Include the partner
–Compensate with other forms of sexual gratification and intimacy
Physical conditions and medications
–Due to age-related changes
Finances
Medical conditions
–Physical conditions can affect sexual function
Erectile dysfunction
–Increased prevalence with age
–Several causes
–Men need to discuss treatment options with their PCP
Medication Adverse effects
–Prepare older adults for the adverse affects affecting sexual function
Cognitive impairment
–Caregivers can make comments to cog impaired that can trigger inappropriate sexual behaviors
–May confuse spouse with a stranger
promoting healthy sexual function for older adults
Sexual history with nursing assessments
Activities promoting sexual function
–Regular exercise
–Good nutrition with limited alcohol intake
–Ample rest
–Stress management
–Good hygiene and grooming practices and enjoyable foreplay
Sexual activities in institutional settings
With masturbation, provide privacy and a nonjudgmental attitude
Sexual satisfaction can have a different meaning in older adults
strategies to facilitate connections
-Assist pts in evaluating current relationships
-Guide patients in becoming aware of the behaviors and responses that impact relationships
-Teach strategies promoting effective expression
of inner feelings
-Provide information on sources of social activists such as senior centers, clubs,etc
-refer patients for hearing and vision exams
-respect patient’s interests and efforts to be sexually active
-assist in improving sexual function with a sexual therapist
-provide positive feedback for efforts
