Journal of Gerontological Nursing

Guest Editorial Free

Sexuality in Older Adults: Changing Misconceptions

Meredith Wallace Kazer, PhD, CNL, APRN, A/GNP-BC, FAAN

The author has disclosed no potential conflicts of interest, financial or otherwise.

There is a prevalent misconception among society that sexual desires diminish with increased age; however, research supports that this is not the case (Lindau et al., 2007; Trompeter, Bettencourt, & Barrett-Connor, 2012). All existing evidence reveals that sexuality is a persistent need, ordinarily present in all human beings and continuing throughout the life span. Although sexual desires persist through life, older adults often advance toward their later years with a variety of normal aging changes, as well as acute and chronic health issues that threaten sexual health. Medications used to manage health issues also impact sexual health and functioning. The role of nurses working throughout assorted care environments is essential to helping older adults maintain sexual health and well-being.

Sexual health has long been considered within the functional health patterns of nursing assessment and management. However, because many nurses do not receive a strong foundation in the care of geriatric sexual health needs, these needs often receive less attention in the provision of nursing care to older adults. Enhanced education is undoubtedly a key factor in ensuring that nursing professionals have the knowledge and clinical experiences to manage the unique sexual health needs of older adults across environments of care. In this special issue of the Journal of Gerontological Nursing, a number of articles are presented that will hopefully expand the knowledge base of nurses regarding many sexual health issues of older adults.

In the first article, “Sexuality and Chronic Illness” (pp. 18–27), Steinke addresses the influence of three commonly occurring medical issues on the sexual health of older adults: cardiovascular disease, pulmonary conditions, and cancer. Using currently available evidence, she examines these illnesses from a physiological perspective and introduces counseling and educational strategies to assist nurses working with these patients. The mediating effect of these chronic medical illnesses on psychological and emotional health is also addressed. Specific recommendations and evaluation of treatment effectiveness on overall sexual health are provided. Activity limitations and alternative sexual practices are also discussed.

“Influence of Cognitive Decline on Sexuality in Individuals with Dementia and Their Caregivers” (pp. 30–36), by Robinson and Davis, explores current evidence on the effect of cognitive decline on sexuality in individuals with dementia. This article also examines the prevalence and satisfaction of sexual relations among partners of individuals with dementia, including levels of affection among dyads. The epidemiology and impact of hypersexuality or inappropriate sexual behaviors among individuals with dementia are explored. In the article “Validity and Reliability of the Geriatric Sexuality Inventory” (pp. 38–45), Kazer, Grossman, Kerins, Kris, and Tocchi identified a lack of instruments to assist in the assessment and management of the sexual health of the older population and began development of such an instrument. Initial pilot testing of the instrument revealed good content validity as well as internal consistency and test–retest reliability. With further testing, the tool will likely be useful in assessing the sexual health needs of older adults and planning appropriate treatments.

In the article “The Invisible Elderly: Lesbian, Gay, Bisexual and Transgender [LGBT] Older Adults” (pp. 46–52), Jablonski, Vance, and Beattie provide an overview of the multidimensional health needs of older LGBT adults. The authors explore the topic within a historical context, expertly illustrating the disparities in health care received by this invisible population of patients and the impact on overall health and function. The authors conclude with recommended strategies for nurses to improve health care environments in which the most culturally sensitive care may be provided. In the final article, “Sexually Transmitted Infections [STIs] and Older Adults” (pp. 53–60), Johnson discusses the epidemiology of STIs among a growing older population and explores risk factors for the development of these diseases among older adults. Screening strategies and nursing assessment essentials are reviewed. She concludes with suggestions for STI treatment and the presentation of excellent resources for the prevention and treatment of STIs among the older population.

Throughout this special issue, nurses are encouraged to delve into the state of the science related to sexual health needs of older adults. It is my hope that with the added knowledge provided by these articles, nurses will be empowered to implement sexual health assessment and management strategies that will improve the quality of life of the ever-rising population of older adults.

Meredith Wallace Kazer, PhD, CNL,

APRN, A/GNP-BC, FAAN

Guest Editor

Professor & Associate Dean

Director of Graduate Programs

Fairfield University School of Nursing

Fairfield, Connecticut

References

  • Lindau, S.T., Schumm, L.P., Laumann, E.O., Levinson, W., O’Muircheartaigh, C.A. & Waite, L.J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357, 762–774. doi:10.1056/NEJMoa067423 [CrossRef]
  • Trompeter, S.E., Bettencourt, R. & Barrett-Connor, E. (2012). Sexual activity and satisfaction in healthy community-dwelling older women. American Journal of Medicine, 125, 37–43. doi:10.1016/j.amjmed.2011.07.036 [CrossRef]

10.3928/00989134-20130916-04

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