Healthy Sexuality Paper

The Importance of Healthy Sexuality and Intimacy in Aging Adults
Sexuality and intimacy are very important in the aging process of older adults. Although sexuality is not often considered, nurses need to be made aware of the importance of assisting older adult’s sexual questions and concerns. Editor Lisa Berry (2009) talks openly in “Nursing Older People” that everyone; including nurses need to become more comfortable talking about sex with older people (p. 3). This paper will discuss the importance of healthy sexuality and intimacy in many different concepts. For myself, healthy sexuality includes both heterosexual and homosexual intimate relationships, sexual fulfillment in the relationship, and the nurse’s role in helping individuals achieve their sexual goals.

Healthy and Intimate Relationships
Maintaining a healthy and intimate relationship begins as one heads toward older adulthood, but also continues and grows during older aging. Whether a person is with a lifelong partner, a new partner, experimenting heterosexually, or homosexually they will have many questions about remaining in a healthy and sexually intimate relationship as their bodies go through the changes of aging (Price, 2009, pp. 32). Sexuality is not just about the act of intercourse, but is also about the act of love. An older adult who is romantically involved may be more concerned with emotional actions, and feeling connected when sharing special moments with one another (Perry, 2009, p. 388). Miller (2004) has written, “most common sexual activities in a sample of 202 adults aged 80 to 102 years were touching and caressing without sexual intercourse,” (p. 483). For a nurse it is important to remember that older adults need their privacy with one another and may become overwhelmed when living in residential care, as they may feel as though their sexual life is coming to an end (Perry, 2009, p. 389). There are many types of intimate relationships to be discussed, most importantly heterosexual and homosexual relationships.

Heterosexual Relationships
Sexuality in heterosexual relationships is often about how one expresses their feminism or masculine attributes to the opposite sex. Not only do aging heterosexual individuals find contact with members of the opposite sex engaging they may also find it as a way of identifying their true personality (Price, 2009, p. 32). Often, changes in environment greatly contribute to heterosexual people finding new partners and opening themselves to sexual happiness. Sometimes this sexual happiness is frowned upon or not completely understood by society. As a nurse it is also important to consider the fact that people of every age require the feeling of being interconnected with a significant other no matter the age (Beare, 2005, pp. 20-21). To myself, it seems as though heterosexual relationships do not differ greatly in the aging when compared to those relationships of younger generations. There are still just as many needs to be fulfilled physically and mentally by sexual relationships.

Homosexual Relationships
Homosexuality is becoming more acceptable in today’s society. The acceptance of homosexuality has shown an increase in the amount of older adults that are known to be homosexual. Sexual changes, such as suddenly announcing a person’s sexual lifestyle preference may be a shock to family members and friends. Nurses should realize that it is very important to stand by an aging adult during these times and support them in their decision. Health care providers should also keep all people well informed and educated about the risks of STI’s and HIV (Beare, 2005, pp. 258-259). Being a homosexual older adult also comes with the fear of not being accepted by peers in all social situations. The baby boomer generation may not be as open about the idea of personal identity with homosexuality and it is important to not only educate the individual but also others in the community as this will hopefully provide support to the older adults (Beare, 2005, p. 259). Beare, Blair, and Stanley (2005) write in great detail about the emotional hardships that gay men have experienced with their sexuality. Many homosexual men grew up in times of anti-gay discrimination that would often push them towards keeping their sexuality a secret. Many homosexual men led double lives, pretending to be heterosexual, or living alone. At times heterosexual citizens are putting themselves at risk for HIV by participating in prostitution, gay clubs, or other risky behavior. Today, it is hoped that both men and women can openly discuss their sexuality and become better educated about these topics without feeling shame or embarrassment. If openness can be accomplished, than homosexual aging partners could accomplish the fulfillment that heterosexual aging partners feel. Homosexual older adults wish to feel the same interconnectedness as other relationships and it is important that these goals are accepted and reached (pp. 258-259).

Sexual Dysfunctions and Fulfillment
Aging greatly changes a person’s sexual activities, whether by desire or by dysfunctions. Kontula, and Mannila, published an extensive study entitled “The Impact of Aging on Human Sexual Activity and Sexual Desire” in 2009 to show the contrast between young people, and older adults sexual lives. This study does not only discuss sexual functioning and responses in both men and women but also gives surprising statistical evidence of how the body and desires change as a person ages. Men and women’s bodies change as they age and they have different problems and situations they may come in contact with. Aging changes not only a person’s physical appearance, but also their hormonal balance and in result, their feelings (pp. 46-48).

Sexual Dysfunctions in Men
“Harvard Men’s Health Watch” (2009) published an article discussing the main problems associated with men’s sexual response dysfunctions that occur as a person ages. Sexual dysfunctions are varied and complex but can be limited to the main functional problems associated with sexual activity. Mental problems or stresses can impact an older man’s sexual interest, and sexual activity itself can be affected. If an older man’s sensory perceptions are effected they may lose sexual pleasure, such as scent, taste, hearing, or touch and as these areas are affected older men may have problems becoming aroused. Failure to be aroused happens because the hypothalamus links with the autonomic nervous system to send impulses through the body, and in aging individuals these signals may not reach the pelvis region, resulting in the lack of an erection. Men who are still able to maintain erections may find that sexual intercourse is not as pleasurable as in their younger years. Older male adults may have maintained an erection, but do not have the ability to ejaculate. If a man does ejaculate during sexual intercourse, they may find that they cannot reach their sexual peak as quickly as they would have been able to when younger. Sexual interest is another very important issue with aging men; and although they may still want to be sexually active, and still have the desire to do so they may not act on their desires (pp. 1-2). The term Andropause describes all of the previously stated reactions that men have during sex as they age. Many of these sexual dysfunctions happen because of lowering testosterone levels in the body (Miller, 2004, p. 483). Nurses should realize that men suffer from many sexual changes due reasons such as age, and illness (Sexuality and seniority, 2009, pp. 1-4).

Sexual Dysfunctions in Women
Although women also have sexual dysfunctions as they age, they are not nearly as severe as men’s. Miller in Nursing for Wellness in Older Adults (2004) wrote that women often are affected by hormonal changes as they hit menopause and older adulthood (p. 483). Hormonal changes can affect a woman much like dropping testosterone levels affect a man. Aging women may lose some of their sexual desire due to depression and mental illness. Because of this women may not feel the need to have sexual activity as often. Kontula, and Manilla’s survey (2009) resulted in showing that this is not always the case; as many women remain with sexual partners as they age (pp. 49-51). An aging woman’s biggest concern is the dryness of the vagina due to the body’s hormonal change. When the body does not feel that a woman can sexually reproduce children any longer it does not produce the appropriate hormones needed to lubricate the vagina. Often, this lack of natural lubrication is accompanied by tightening of the vaginal walls. Luckily in two of three cases this lack of vaginal lubrication not a serious problem. In addition most women are not overly bothered with self-esteem issues, and have fewer problems than men with sexual dysfunctions (Kontula, 2009, p. 52).

Nursing Role in Healthy Sexual Aging
Nurses should always take into consideration a person’s sexual preference, and their sexual abilities when treating an older adult. Older adults are often embarrassed or ashamed to talk about sex with health professionals, but if nurses make the first step then they will be more likely to open up about any sexual issues or questions they may have (Berry, 2009, p. 3). Nurses should be a support system for older adult citizens as they go through the changes their bodies are experiencing during aging. Nurses should not be afraid to be compassionate, and they should try to answer any questions an older adult has in a well-educated, comfortable manner (Price, 2009, p. 37). No-matter what the subject is, a nurse should be well educated about what the client has concern for. Nurses should constantly observe his or her client in their social settings and notice whether they seem comfortable or if there are issues that the client is not being forthcoming about. A nurse should be constantly trying to assist clientele with everyday activities, problems, or concerns they have to make their overall living experience healthy. In conclusion, sexuality is a topic often avoided by nurses, as they are uncomfortable with the issue and this is something that has to be changed (Miller, 2004, p. 485).

Conclusion
My own belief is that nurses should try to be understanding educators no matter what the situation entails. Nurses should be supportive of intimate relationships between older adults, no matter if they are heterosexual or homosexual. Nurses should also be able to educate a client on sexual dysfunctions, whether they are men or women, all while being comfortable in doing so. Being able to relate to a client, and helping them in any way you can as a nurse will help increase their health in sexuality and intimacy throughout the aging process.



References

(2009). Sexuality and seniority. (Cover story). Harvard Men’s Health Watch, 13(10), 1-4. http://search.ebscohost.com
Beare, P. G., & Blair, K. A., & Stanley, M. (2005). Gerontological Nursing: Promoting successful aging with older adults. (pp. 20-21, 255-265). Philadelphia. F.A. Davis Company.
Berry, L. (2009). Sexuality and Older People. Nursing in Older People, 21(6), 3. http://search.ebscohost.com
Kontula, O., & Haavio-Mannila, E. (2009). The Impact of Aging on Human Sexual Activity and Sexual Desire. Journal of Sex Research, 46(1), 46-56. http://search.ebscohost.com, doi:10.1080/00224490802624414
Miller, C. A. (2004). Nursing for Wellness in Older Adults. (pp. 473-499). Philadelphia.Lippincott Williams & Wilkins.
Perry, A. G., & Potter, P. A., (Eds.). (2009). Canadian Fundamentals of Nursing. (pp. 388-389). Toronto. Mosby Elsevier
Price, B. (2009). Exploring attitudes towards older people’s sexuality. Nursing Older People, 21(6), 32-39. http://search.ebscohost.com