Journal of Gerontological Nursing

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Sexuality

Meredith Wallace

Abstract

WHY

Although it is commonly believed that sexual desires diminish with age, several researchers have identified that sexual patterns persist throughout the life span. The landmark study by Masters and Johnson (1986) indicates that older adults continue to enjoy sexual relationships throughout each decade of their lives. The expression of sexuality among older adults results in a higher quality of life achieved by fulfilling a natural desire.

Although the need to express sexuality continues among older adults, they are more susceptible to many disabling medical conditions such as cardiac problems and arthritis, as well as normal aging changes that may make the expression of sexuality difficult. In addition, the treatments used for medical conditions may also hinder the older adult's sexual response. Nurses are in an ideal position to assess these normal aging changes, as well as disabling medical conditions and medications, and to intervene at an early point to prevent or to correct sexual problems.

BEST TOOLS

The PLISSIT (i.e., Permission, Limited Information, Specific Suggestions, Intensive Therapy) model (as shown in the Figure) has been used to assess and manage the sexuality of adults (Annon, 1976). The model includes several suggestions for initiating and maintaining the discussion of sexuality with older adults. Suggested questions to guide the discussion of sexuality are provided in the Table.

TARGET POPULATION

The PLISSIT model and the suggested questions may be used with older adults in a variety of clinical settings. The goal of the assessment is to gather information allowing clients to express their sexuality safely and to feel uninhibited by normal or pathologic problems. It is common for health care professionals to feel uncomfortable with assessing the sexual desires and functions of all clients. Regardless, a sexual assessment should be performed as a routine part of the nursing assessment. Knowledge, skill, and a sense of one's own feelings and sexuality will provide the comfort necessary for the nurse to assess the sexuality of older adults.

VALIDITY/RELIABILITY

Despite the findings that sexuality continues throughout all phases of life, little material, scientific or otherwise, exists in the literature to guide nurses toward assessing the sexuality of older adults. Consequently, validity and reliability to support the PLISSIT model or the suggested questions are not available. Further research in the area of sexuality among older adults is imperative.

STRENGTHS AND LIMITATIONS

The PLISSIT model and suggested questions are not diagnostic in any manner but rather provide guidance for further work-up or referral. As sexuality is discussed, the model and questions provided help initiate and maintain discussions of sexuality.

TABLE

QUESTIONS TO GUIDE SEXUALITY ASSESSMENT AMONG OLDER ADULTS…

WHY

Although it is commonly believed that sexual desires diminish with age, several researchers have identified that sexual patterns persist throughout the life span. The landmark study by Masters and Johnson (1986) indicates that older adults continue to enjoy sexual relationships throughout each decade of their lives. The expression of sexuality among older adults results in a higher quality of life achieved by fulfilling a natural desire.

Although the need to express sexuality continues among older adults, they are more susceptible to many disabling medical conditions such as cardiac problems and arthritis, as well as normal aging changes that may make the expression of sexuality difficult. In addition, the treatments used for medical conditions may also hinder the older adult's sexual response. Nurses are in an ideal position to assess these normal aging changes, as well as disabling medical conditions and medications, and to intervene at an early point to prevent or to correct sexual problems.

BEST TOOLS

The PLISSIT (i.e., Permission, Limited Information, Specific Suggestions, Intensive Therapy) model (as shown in the Figure) has been used to assess and manage the sexuality of adults (Annon, 1976). The model includes several suggestions for initiating and maintaining the discussion of sexuality with older adults. Suggested questions to guide the discussion of sexuality are provided in the Table.

TARGET POPULATION

The PLISSIT model and the suggested questions may be used with older adults in a variety of clinical settings. The goal of the assessment is to gather information allowing clients to express their sexuality safely and to feel uninhibited by normal or pathologic problems. It is common for health care professionals to feel uncomfortable with assessing the sexual desires and functions of all clients. Regardless, a sexual assessment should be performed as a routine part of the nursing assessment. Knowledge, skill, and a sense of one's own feelings and sexuality will provide the comfort necessary for the nurse to assess the sexuality of older adults.

Figure. PLISStT Model.

Figure. PLISStT Model.

Table

TABLEQUESTIONS TO GUIDE SEXUALITY ASSESSMENT AMONG OLDER ADULTS

TABLE

QUESTIONS TO GUIDE SEXUALITY ASSESSMENT AMONG OLDER ADULTS

VALIDITY/RELIABILITY

Despite the findings that sexuality continues throughout all phases of life, little material, scientific or otherwise, exists in the literature to guide nurses toward assessing the sexuality of older adults. Consequently, validity and reliability to support the PLISSIT model or the suggested questions are not available. Further research in the area of sexuality among older adults is imperative.

STRENGTHS AND LIMITATIONS

The PLISSIT model and suggested questions are not diagnostic in any manner but rather provide guidance for further work-up or referral. As sexuality is discussed, the model and questions provided help initiate and maintain discussions of sexuality.

REFERENCES

  • Annon, J. (1976). The PLISSIT model: A proposed conceptual scheme for behavioral treatment of sexual problems, Journal of Sex Education Therapy, 2(2).
  • Masters, W.H. (1986). Sex and aging - expectations and reality. Hospital Practice, August 15.
  • Wallace, M. (2000). Sexuality and Intimacy: Textbook of Gerontologtcal Nursing. St. Louis: Mosby Year Book.

TABLE

QUESTIONS TO GUIDE SEXUALITY ASSESSMENT AMONG OLDER ADULTS

10.3928/0098-9134-20010201-08

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