Gender and aging presentation


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Gender and aging presentation

  1. 1. Barriers to Sexuality Carolyn Coons Holly Sansolo Carin Knight Colleen Szabo Danielle Cooney
  2. 2. Outline <ul><li>Statistics for Intimacy within Older Adults </li></ul><ul><li>Social Barriers </li></ul><ul><li>Physical Barriers </li></ul><ul><li>Emotional Barriers </li></ul><ul><li>Environmental Barriers </li></ul>
  3. 3. Study One <ul><li>New Jersey Study involving 179 participants, living in subsidized housing </li></ul><ul><li>62% of men and 30% of women reported currently partaking in sexual intercourse </li></ul><ul><li>Most of the elderly surveyed wanted to maintain a sexual relationship, and would like to have more sexual experiences than accessible </li></ul><ul><li>For all of the categories of physical and sexual experiences, subjects wanted more of an opportunity to engage in sexual activity than they were experiencing </li></ul>
  4. 4. Study Two <ul><li>3005 Adults (age 57-85), a nationally representative sample </li></ul><ul><li>41% of oldest age group rated sex as “not at all important” </li></ul><ul><li>25% of middle age group rated sex as “not at all important” </li></ul><ul><li>15% of youngest age group rated sex as “not at all important” </li></ul><ul><li>Women more likely to rate sex as “not at all important” (35% compared to 13%men) </li></ul>
  5. 5. Study Three <ul><li>44 people interviewed, age 50 and over, asked to rate importance of sex. </li></ul><ul><li>12 subjects rated sex not important </li></ul><ul><ul><li>8 of these participants were widowed or divorced. The 4 who had partners reported sexual barriers </li></ul></ul><ul><li>15 participants rated sex as moderately important </li></ul><ul><ul><li>4 people claimed that sex became less important due to a health related issue </li></ul></ul><ul><li>15 reported sex as very/extremely important </li></ul><ul><ul><li>All but one participant had a regular sexual partner </li></ul></ul>
  6. 6. Lack of a Partner <ul><li>Study One- 60% of people said lack of a partner was the largest barrier </li></ul><ul><li>Study Two- Women are less likely to have a partner. 40% of women report having a spousal or intimate relationship compared to 78% of men </li></ul><ul><li>Study two- among those not in a relationship, 22% of men and 4% of women reported being sexually active in the past year </li></ul>
  7. 7. Sexuality does not exist <ul><li>Societal belief that </li></ul><ul><ul><li>old people should be asexual </li></ul></ul><ul><ul><li>Physical attractiveness depends on youth and beauty </li></ul></ul><ul><li>Many young people do not consider older people as sexual beings because this means acknowledging their parents as having sexual interests </li></ul>
  8. 8. Sexuality is Funny “ That’s if you can stand the sight of someone your age naked” Like where you left your car keys, what your bank pin number is, where you parked your car…”
  9. 9. … but a heart attack is more likely!! Happy Birthday”
  10. 11. Sexuality is Disgusting <ul><li>An elderly person who deviates from the asexual stereotype may be ridiculed. This is harder for men(“dirty old man”). </li></ul><ul><li>Older adults are reluctant to verbalize their sexual feelings for fear of being seen as “depraved or lecherous” </li></ul><ul><li>Fear of changing body (change from youth and “beauty” to old and “ugly”) </li></ul>
  11. 12. Physical Barriers <ul><li>Poor health was found to be negatively associated with sexual problems in old people. Health problems can restrict older adults from being sexual beings and sexual problems can be a consequence of illnesses such as diabetes, an infection or cancer. </li></ul>
  12. 13. Physical Restrictions <ul><li>Impotency </li></ul><ul><li>Disabilities </li></ul><ul><li>Poor mobility </li></ul><ul><li>Arthritis </li></ul><ul><li>Cardiac disease </li></ul><ul><li>Hypertension </li></ul><ul><li>Change of body image </li></ul>
  13. 14. Erectile Dysfunction <ul><li>Causes </li></ul><ul><li>Diagnosing </li></ul><ul><li>Medications </li></ul><ul><ul><li>Sexuality Counseling </li></ul></ul><ul><ul><li>Perscriptions </li></ul></ul><ul><ul><li>Last Resorts </li></ul></ul>
  14. 15. Disabilities <ul><li>Disability prevalence is higher among women 65 years and older, (Fried & Guralnik,1997). </li></ul><ul><li>Causes </li></ul><ul><li>Disabilities </li></ul><ul><ul><li>Mobility </li></ul></ul><ul><ul><li>Health </li></ul></ul>
  15. 16. How chronic illness affects sexuality <ul><li>Chronic illnesses can physically affect how older adults go about being sexual. Because of their poor health, it makes having sexual intercourse and having a sexuality very difficult in older people. This in turn can make the sexual process dangerous and can make the person fearful of participating in sexual activity or from having a sexuality. </li></ul>
  16. 17. Health problems <ul><li>Other health problems that can reduce the amount of physical sexual activity that older people have include: </li></ul><ul><li>Rheumatoid arthritis </li></ul><ul><li>Parkinson’s disease </li></ul><ul><li>Hypertension </li></ul><ul><li>Cardiac disease </li></ul>
  17. 18. How rheumatoid arthritis affects sexuality <ul><li>Rheumatoid arthritis is defined as a inflammatory disease that affects the linings of multiple joints, especially the hands and feet ( ). This is often a painful disease which can make an individual physically disabled. Because of the debilitating effects of this disease, it can keep older adults from having little to no sexual activity. </li></ul>
  18. 19. Medication <ul><li>Medication is also a factor in restricting older adults. Certain medications gave off side effects that made it difficult to engage in sexual activity. This in turn made patients discontinue their medicine. </li></ul><ul><li>Medications that are used to treat sexual problems also caused negative effects in older people’s sex lives </li></ul>
  19. 20. Medication continued <ul><li>Some medications also gave other side effects that made it difficult for older people to have sexual activity. These side effects were medications that caused impotence or lack of libido </li></ul>
  20. 21. What can be done to fix physical restrictions <ul><li>There are many ways in how older people can go about fixing some of their sexual problems so that they can continue physical and sexual activity. </li></ul><ul><li>Oestrogen creams, estrogen, hormone replacement therapy for women who experience vaginal dryness </li></ul><ul><li>Erections medications for men (viagra, sildenafil) </li></ul><ul><li>Getting into better physical health can also help older people fix physical restrictions and keep them sexual beings. </li></ul>
  21. 22. Effects of Dementia on Sexuality In Old Age
  22. 23. Consent <ul><li>“ The onset of progression of dementia is characterized by cognitive and communicative impairment, presenting various challenges to communication and understanding.” </li></ul><ul><li>- Can an individual with dementia consent to sexual activity? </li></ul><ul><li>-Sexuality is regarded as problematic when associated with dementia </li></ul><ul><li>-caregivers are ethically and legally responsible to monitor and confirm an individuals ability to consent to sexual activities. </li></ul><ul><li>Patients autonomy vs. Perceived risk </li></ul>
  23. 24. Majority of research done on this topic focuses on the way in which nursing home caregivers handle these situations. <ul><li>Gendered response to sexual expression in these settings. </li></ul><ul><li>Male: </li></ul><ul><ul><li>Sexual expression is more frequent and is more often noted by the care taker. </li></ul></ul><ul><ul><li>More likely to be looked down upon or punished for sexual expression. </li></ul></ul><ul><ul><li>Apology is recognized as an indicator of consciousness regarding actions. </li></ul></ul><ul><li>Female: </li></ul><ul><ul><li>Sexual expression is not as frequent and often overlooked </li></ul></ul><ul><ul><li>Not seen as threatening to the man’s safety </li></ul></ul><ul><ul><li>The concern lies on masculine attention that a female resident may attract. </li></ul></ul><ul><li>Punish vs. Protect mentality used in relation to sexual expression amongst residents with dementia. </li></ul>
  24. 25. Nursing Home Caregiver Responses <ul><li>Caregiver denial </li></ul><ul><ul><li>Ignoring sexual advances or assuming stereotypes </li></ul></ul><ul><li>Caregiver bias: </li></ul><ul><ul><li>Majority of individuals in caregiver roles within nursing home settings are female. </li></ul></ul><ul><ul><li>This has been assumed to have an effect on the ways in which sexual expression is both interpreted and responded to. </li></ul></ul>
  25. 26. Dementia Within Marital Relationships <ul><li>One of the only studies that focus’s on marital couples opinions and experience opposed to collecting research from nursing home caregivers. </li></ul><ul><li>Changes within Marital relationship </li></ul><ul><ul><li>Intimate partner  parent figure </li></ul></ul><ul><ul><li>Role reversals or shifts </li></ul></ul><ul><ul><li>New identification with the term intimacy </li></ul></ul>
  26. 27. Two ultimate perspectives emerged in relation to sexuality in aging couples with the presence of dementia: <ul><li>1. Less sexual but more intimate </li></ul><ul><li>2. Limited intimacy on multiple levels </li></ul>
  27. 28. Less sexual but more intimate: Commitment, physical closeness, appreciation <ul><li>“ My wife has been suffering with a myriad of other health ailments that she's had for some time. She's faced quite a bit upon her. In terms of her sexuality, I would say it's probably less in terms of the physical now. The intimacy, the emotional intimacy, psychological intimacy, is stronger I feel. It has allowed me, perhaps to look deeper into myself, which is something men may have difficulty doing.” </li></ul><ul><li>“ You become not just a role player; you go back to these vows you took. How you were standing up and how they tell, from death do us part, united for better or for worse. I always felt that she would give her heart and soul to do the same for me. It was never a question in my mind about what I had to do.” “A woman expressed her closeness to her husband this way: “I guess after everything's done and the dishes are put away and we sit together on the couch. And he will have his arm around me and we still talk. That is the very best, the most intimate time” </li></ul>
  28. 29. Limited Intimacy on Multiple Levels Loss of identity, connectedness, anger and betrayal by partner leaving. <ul><li>I'm not who he married anymore. There's pieces of me missing. There are little pieces of me sort of breaking away… little chunks. If I was to see this little clay doll of myself, there's a piece there gone, and there's a piece here gone. My shoulder, my leg, my foot in my boot are gone, broken away. But it's the thought that we're trying to put the whole clay person together and it won't hold up. It's no longer a solid piece of clay. It's crumbling. I see so many changes this past month. I don't recognize who I am right now. </li></ul><ul><li>It's like the emotional part is just totally gone. It's hard, any intimacy. We used to go to the movies a lot, hold hands, and do those kinds of things. Little by little, everything that we had done as a couple is just gone. But, he still kisses me goodnight and tells me how much he loves me. But as far as any intimacy or anything like that, well.… </li></ul><ul><li>I received the diagnosis of loss of memory from Alzheimer's. I became impotent about 4 weeks after that, after the diagnosis. Our sex life was pretty adequate, quite good. This eliminates that. I have not found any ease or [way to be] comfortable with this, any way not to be angry. </li></ul>
  29. 30. Other effects on sexuality: <ul><li>- Care taking partner is exhausted after picking up responsibilities of their partner. As a result, sex drive is diminished. </li></ul><ul><li>- Due to medications partner with dementia may lose ability to become sexually aroused, to perform sexually. </li></ul><ul><li>May lose desire for or even lose memory of who partner is. </li></ul><ul><li>May forget what sexual intimacy is all together. </li></ul>
  30. 31. <ul><li> </li></ul>
  31. 32. Environmental Barriers <ul><li>What environmental barriers do older adults face when it comes to sexuality? </li></ul><ul><ul><li>Long term care settings </li></ul></ul><ul><ul><ul><li>Privacy </li></ul></ul></ul><ul><ul><ul><li>Comfort </li></ul></ul></ul><ul><ul><ul><li>Attitudes of staff </li></ul></ul></ul>
  32. 33. Research on Long Term Care <ul><li>Study done by Bonnie L. Walker, Ph. D and Paul Ephross, Ph. D </li></ul><ul><li>Studied 13 elderly people living in long-term care and 55 elderly people who lived in the community </li></ul><ul><li>50% of those studied said they were in an intimate sexual relationship </li></ul><ul><li>Study was done as a basis for training staff to be more sensitive to patient’s sexual needs </li></ul>
  33. 34. Research on Long Term Care <ul><li>Resident’s Rights </li></ul><ul><ul><li>80% of respondents believed that residents have a right to sexual expression </li></ul></ul><ul><ul><li>95% said that residents have a right to privacy </li></ul></ul><ul><ul><li>93% believed that staff should knock before entering a patient’s room (privacy) </li></ul></ul>
  34. 35. Research on Long Term Care <ul><li> Patients with dementia in long term care </li></ul><ul><ul><li>53% believed that patients with dementia are not capable of consenting to a sexual relationship </li></ul></ul><ul><ul><li>27% believe they are and 20% did not respond </li></ul></ul>
  35. 36. Conclusions <ul><li>Elderly people living in long term care settings believe they have a right to sexual intimacy </li></ul><ul><li>They also believe that staff should be supportive and not embarrassed to discuss sexual needs of patients </li></ul><ul><li>Implications </li></ul><ul><ul><li>Training of staff members </li></ul></ul><ul><ul><li>Sensitivity to diversity among sexuality of patients </li></ul></ul>
  36. 37. Ethically Managing Sexual Activity in Long Term Care <ul><li>Study done by Bethan Everett </li></ul><ul><li>Sexual lives of LTC resident’s is often ignored </li></ul><ul><li>Provides an ethical framework that health care professionals should follow when it comes to intervening in the sexual lives </li></ul>
  37. 38. Ethically Managing Sexual Activity in Long Term Care <ul><li>Conclusions </li></ul><ul><li>Legal Perspective: </li></ul><ul><ul><li>Unless the law specifically prohibits something then it cannot be used to interfere </li></ul></ul><ul><li>Ethical Criteria: </li></ul><ul><ul><li>− harm to self </li></ul></ul><ul><ul><li>− harm to others </li></ul></ul><ul><ul><li>− offense to others </li></ul></ul><ul><li> Everett suggests using these guidelines when it comes to intervening in the sexual activity of elderly living in LTC </li></ul>
  38. 39. Staff Training <ul><li>Study done by Bonnie L. Walker and Donna Harrington </li></ul><ul><li>Developed a program that could be used to effectively train staff to be sensitive to sexual needs of patients in LTC </li></ul><ul><li>It was found that participation in the training program resulted in an increased sensitivity to patients’ needs </li></ul>
  39. 40. Staff Training <ul><li>What does this mean? </li></ul><ul><ul><li>Training staff to be more knowledgeable and sensitive when it comes to the sexuality of the residents can improve the lives of residents in LTC </li></ul></ul><ul><ul><li>Training programs are easily designed and implemented </li></ul></ul>
  40. 41. Conclusions <ul><li>Society has a negative opinion towards older adults partaking in sexual activity </li></ul><ul><ul><li>When it comes to older adults sexuality is seen as both humorous and disgusting </li></ul></ul><ul><li>Elderly adults have physical limitations that can hinder them from being sexually active </li></ul><ul><ul><li>Chronic illness and disabilities </li></ul></ul><ul><li>There are environmental barriers that inhibit elderly people from engaging in sexual activity </li></ul><ul><ul><li>Long term care settings and policies </li></ul></ul>