Week 11: Intimacy And Sexuality Flashcards
(40 cards)
1
Q
Intimacy and Sexuality: Therapeutic Touch
A
Touch can serve as a means of providing sensory stimulation, reducing anxiety, relieving physical and psychological pain, and comforting the dying, as well as sexual expression.
2
Q
Categories of touching include
A
- Intimate zone
- Vulnerable zone
- Consent zone
- Social zone
3
Q
Intimate zone includes
A
Genitalia
4
Q
Vulnerable Zone includes
A
- Face
- Neck
- Front of body
5
Q
Consent Zone includes
A
- Mouth
- Wrists
- Feet
6
Q
Social Zone includes:
A
- Hands
- Arms
- Shoulders
- Back
7
Q
Touch Deprivation
A
- “Tactile hunger” becomes more powerful in later life when other sensuous experiences are diminished and direct sexual expression is often no longer possible or available.
- The cause of illness may be greatly influenced by the quality of tactile support received.
8
Q
Therapeutic Touch
A
- Touch is a powerful healer and a therapeutic tool that nurses can use to satisfy “touch hunger” of older adults.
- Touch is a powerful tool to promote comfort and well-being when working with older adults.
9
Q
Touch can serve as a means of providing
A
- Sensory stimulation
- Reducing anxiety
- Relieving physical and psychological pain
- Comforting the dying
10
Q
Intimacy encompasses more than sexuality including
A
- Commitment
- Affective intimacy
- Cognitive intimacy
- Physical intimacy
- Love and affection (more important to older persons)
11
Q
Sexuality
A
- Is a central aspect of being human and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction.
- Sexuality is a basic human need, yet it goes beyond the biological realm to include psychological, social, and moral dimensions.
12
Q
Sexuality provides
A
opportunity to express passion, affection, admiration, and loyalty.
13
Q
Sexuality: Social Domain
A
Sum of cultural factors that influence thoughts and actions related to interpersonal relationships, as well as sexuality related to ideas and learned behavior.
14
Q
Sexuality: Psychological Domain
A
Reflects attitudes, feelings toward self and others, and learning from experiences.
15
Q
Sexuality: Biological Domain
A
Reflected in physiological responses to sexual stimulation, reproduction, puberty, and growth and development.
16
Q
Sexual Health
A
state of physical, emotional, mental, and social well-being related to sexuality.
17
Q
Sexual Health Includes Four Components:
A
- Personal and social behaviors in agreement with gender identity.
- Comfort with range of sexual role behaviors and engagement in effective interpersonal relations with both sexes in a loving relationship or long-term commitment.
- Response to erotic stimulation that produces positive and pleasurable results.
- Ability to make mature judgments about sexual behavior that is culturally and socially acceptable.
18
Q
Factors Influencing Sexual Health
A
- Expectations
- Activity levels: Determinants of sexual activity and functioning include the interaction of each partner’s sexual capacity, physical health, motivation, conduct, and attitudes, as well as the quality of the relationship.
- Cohort and cultural influences
- Biological change with aging
19
Q
Common Myths about Sexuality and Aging in Women
A
- Masturbation is an immature activity of youngsters and adolescents, not older women.
- Menopause is the death of woman’s sexuality.
- Hysterectomy creates physical disability that results in inability to function sexually.
- Sex has no role in lives of elderly, except as perversion or remembrance of times past.
- Sexual expression in old age is taboo.
- Older people are too old and frail to engage in sex.
- Sex is unimportant or over in the lives of the older adult.
- Older women do not wish to discuss their sexuality with healthcare professionals.
20
Q
Sexual Dysfunction
A
-An impairment in normal sexual functioning
21
Q
Sexual Dysfunction causes are both physical and psychological
A
- Hypoactive sexual desire disorder
- Sexual arousal disorder
- Sexual pain disorders
22
Q
Inhibitors of Sexual Activity
A
- Chronic Pain
- Chronic Diseases (CVA, COPD, Diabetes, Cancer)
- Osteoarthritis
23
Q
What are interventions for inhibitors of sexual activity?
A
- Pain medication
- Warm baths
- Alternative positions (Fig. 33-3; pg. 455)
- Check with provider before engaging in sexual intercourse
24
Q
Male Sexual Dysfunction
A
- Erectile dysfunction (ED) is the most prevalent sexual problem in men.
- Inability to achieve or sustain an erection sufficient for satisfactory sexual intercourse in at least 50% of attempts.
- Erection is governed by interaction among hormonal, vascular, and nervous systems and a problem with any of these can cause ED.
- The use of Viagra, Levitra, and Cialis has revolutionized treatment for ED regardless of cause.
25
Impotence
Inability to achieve and sustain an erection sufficient for satisfactory sexual intercourse in at least 50% or more attempts
26
Erectile Dysfunction usually is caused by underlying medical diagnosis
- Vascular problems (i.e. endothelial dysfunction)
- Endocrine problems
- Neurological problems
- Structural abnormalities of penis
- Depression
- Zinc deficiency
- Alcoholism
- Diabetes mellitus
- Medications (i.e. Beta Blockers)
- Psychological problems
27
Female Sexual Dysfunction
- Considered “persistent impediment to a person’s normal pattern of sexual interest, response, or both”.
- Postmenopausal changes in the urinary or genital function as a result of lower estrogen levels can make sexual activity less pleasurable.
- Women can experience arousal and orgasmic disorders resulting from drugs.
- Urinary incontinence may affect sexual activity.
- Influenced by factors such as culture, ethnicity, emotional state, age, previous sexual experience, and age-related changes.
28
LGBT
- Discrimination in health and social systems affects LGBT individuals of all ages.
- Older individuals may be more at risk for discrimination as a result of lifelong experiences with social exclusion and being subject to unjust treatment.
- They are much less likely to access needed health services or identify themselves to healthcare providers.
- Transgender older adults have the most difficulty accessing health care.
- Older LGBT individuals more likely to have kept their relationships hidden than those who grew up in modern day LGBT movement.
29
LGBT Assessment
- Healthcare providers may assume LGBT patients are heterosexual and neglect to obtain a sexual history.
- Use open-ended questions “Who is important to you?” or “Do you have a significant other?”
- If a person identifies as transgender, it is important to ask how he or she wishes to be addressed.
- Euphemisms (mild or indirect word or expression substituted for one considered to be too harsh or blunt when referring to something unpleasant or embarrassing) are frequently used for a life partner.
30
LGBT Interventions: Better support and care for LGBT individuals by healthcare providers should include
- Working through homophobic attitudes and discomfort while discussing sexuality.
- Learning about special issues LGBT face.
- Becoming aware of resources in the community specific to this population.
31
Intimacy and Chronic Illness
- Chronic illness and its related treatments may bring challenges to intimacy and sexual activity.
- Persons are given little or no information about the effect of illness on sexual activity or strategies to continue sexual activity within functional limitations.
32
Benefits of Masturbation
Masturbation provides an avenue for resolution of sexual tension, keeps sexual desire alive, maintains lubrication and muscle tone of the vagina, provides mild physical exercise, and preserves sexual function.
33
Intimacy and Sexuality and LTC Facilities
Privacy is a major issue in nursing homes that can prevent fulfillment of intimacy and sexual need.
34
Interventions for Intimacy and Sexuality in LTC Facilities
- Staff, resident, and family education programs to promote awareness.
- Provide education on sexuality and intimacy in later life.
- Involve residents in discussions of sexuality.
- Discuss interventions to respond to residents’ needs.
35
Intimacy, Sexuality and Dementia
- Intimacy and sexuality remain important in the lives of persons with dementia and their partners.
- Intimacy and sexuality may “serve as a nonverbal form of communication and intimacy when other cognitive skills have declined”.
- As dementia progresses, particularly in LTC, intimacy and sexuality issues may present challenges, especially regarding the impaired person’s ability to consent to sexual activity and require accurate assessment and documentation.
36
Inappropriate sexual behavior in LTC settings may be triggered by
- unmet intimacy needs or may be symptoms of underlying physical problems, such as urinary or vaginal infection.
- An interdisciplinary sexual assessment to determine the underlying need the person is expressing and how it might be addressed is important.
37
HIV/AIDS in Older Adults
- An increasingly significant trend in the global HIV epidemic is the growing number of people aged 50 years and older who are living with HIV.
- 37% of people in the United States with HIV are over age 50.
- The largest increase in HIV diagnoses from 2008 to 2010 was among people aged 65 and older.
- The compromised immune system of an older person makes him or her more susceptible to HIV/AIDS.
- Sexually active older men and women do not routinely use condoms.
38
HIV/AIDS and Older Adults: Assessment
- A thorough sex and drug use/assessment screening should be conducted with attention to HIV risk factors.
- Many symptoms such as fatigue, weakness, weight loss, and anorexia are common to other disease conditions and may be attributed to normal aging.
- Many U.S. guidelines recommend HIV testing among high-risk groups regardless of age but routine screening recommendations differ and some have a cutoff age of 65 years.
- Medicare covers annual screenings for HIV for those at risk or who ask for a test.
39
HIV/AIDS in Older Adults: Interventions
- Antiretroviral therapy can be more complicated if there are chronic illnesses, comorbidities, and polypharmacy.
- Guidelines for care of adults 60-80 years of age with HIV are limited due to not studied in clinical/pharmacokinetic trials.
- Misinformation about HIV is more common in older adults.
- Educational materials and programs aimed at older adults need to be developed that include information about what HIV/AIDS is, how it is transmitted, risk reduction counseling, symptoms of which to be aware, and the treatments that are available.
40
Promotion of Healthy Aging: Sexual Health
- Anticipation of problems in older individual’s sexual experiences can ward off anxiety, misconception, and arbitrary cessation of sexual pleasure.
- Screen for HIV/AIDS and other sexually transmitted diseases (Box 33-7; pg. 458).
- Guidelines for talking to older adults about sexual health (Box 33-8; pg. 459)
- PLISSIT Model -- guide for discussion of sexuality
