Sexuality in aging: its characteristics

They have recently talked about Sexuality in older people in his latest research Feliciano Villar, Carme Triadó, Montse Celdrán and Josep Fabà; Psychogerontologists with extensive training and experience. They refer to the perspective of the institutionalized elderly person, but also to the perspective of the professional.

It is clear, on the one hand, that many drugs that treat neurodegenerative diseases in the third and fourth age cause as a side effect behaviors related to hyperxesuality and / or sexual conduct disorders that are so difficult for a healthcare professional to treat or redirect socio-sanitary. In fact, the uninhibited behavior of the elderly person in relation to the Assistant is usually common.

That is why this article deals with sexuality in aging, as well as the most important conclusions that said authors have agreed after their investigation; Because it is very important to have a good understanding of Sexuality in Aging to treat older people from Person-Centered Care and offer the highest possible quality of life.

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Sexuality in aging

It is a reality that almost all people, from birth to death, have sexuality, as well as the need to have sex with others and alone. Therefore it is also a reality that today in residential centers there is a very relevant lack of privacy as well as individualized monitoring of the elderly due to lack of resources, professionals and, above all, training and communication.

In fact, as Villar, F., Triadó, C., Celdrán, M., Fabà, J. (2017), after having interviewed elderly residents and professionals, some of them comment that there are professionals who tend to have negative and very pejorative reactions to older people expressing their sexual affective needs both in public and in public private; In general, we do not react naturally, neither elderly nor professionals, precisely because there is a clear stigmatization in the third and fourth age, in addition to ageism (ageism).

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What are the sexual needs in aging?

According to the elderly participating in the research and according to the professionals, in this case 83 out of a total of 100, explain that sexual needs are maintained throughout the aging process, although not fully. However, some particularly consider that "interest is maintained but practice declines", and the intensity of sexual needs decreases but does not disappear.

In any case, sexual needs in Aging, as in the Adult Stage, will depend above all on the Life History, as well as on the vulnerability to certain neurodegenerative and / or neuropsychiatric diseases, since sexual desire is closely related to these diseases, which are also so frequent. This set, then, must be reviewed by a social health professional, in this case the Psychogerontologist either in Residential Centers or in Home Care Startups; in order to preserve in the best possible way the privacy of the person and facilitate sexual expression since, according to the authors, there are two barriers that require work:

Internal Barriers

Modesty and feelings of shame In the face of sexuality in old age, they are the greatest ageisms that exist, the greatest esteem, the greatest internal barrier. We talk about moral rules and generational factors such as repressive education.

External Barriers

The context in the Residential Centers as the context in the Home as well as the infrastructure of the space in which the elderly person is located is the main external barrier. In Residential Centers, due to lack of resources, they tend to live in shared spaces with a clear lack of privacy and at home, infantilization and overprotection are frequent. In this case, in the Centers the individual rooms would be a Facilitator and in the Home it would be an adequate clinical evaluation of the elderly person as well as of their context.

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Barriers and facilitators to the expression of libido

What can we professionals do about this? According to Villar, F., et al. “When asked about the most frequent sexual behaviors among residents, the majority of those who answered (many residents do not, since they consider that this dimension is absent in institutions), masturbation is the most mentioned. Practically all professionals mention this type of behavior, of which in many cases they have been involuntary witnesses ”. So, what are the objectives and strategies to follow?

1. In relation to the elderly

Know first-hand his Life Story as well as evaluate and treat your neurodegenerative diseases and study the possible side effects of his psychopharmacological treatment.

2. In relation to the context

Due to the lack of resources, it is difficult to have individual rooms in the Residential Centers, so ultimately the best option is to ensure that they delay and / or avoid admission to these centers through the help of new home care startups.

3. In relation to the entire professional staff

Promote continuous communication between Nursing Assistants and Psychogerontologists in order to offer person-centered care in the best possible way. Advising, in addition, is one of the main characteristic functions of social health professionals of the third and fourth age.

Sexuality and Dementia: 3 points to keep in mind

When the dementias and sexuality overlap, the following points must be taken into account.

1. Discerning consent

Nursing Assistants with more than one patient in charge usually find themselves in situations in which they do not know how to handle the situation. Of course, a sexual relationship between two people who have dementia or in a couple in which one of the two suffers from neurodegenerative disease creates a lot of uncertainty, making it difficult to know how to discern consent from old person. This is why Prevention and Monitoring is important.or carried out between Psychogerontologists and Assistants horizontally in order, through the ACP, to find a solution.

2. Advise and collect information

Sometimes, the reactions of professionals as well as Nursing Assistants, Social Workers, Nurses, Psychogerontologists, etc., and / or relatives are not correct so Infantilization can happen. This is why it is essential to stay informed and provide communication between professionals in order to advise and gather information from the different parties involved.

3. To de-dramatize

De-dramatize and avoid uninhibited behavior of the elderly person, if it is the case, they are the key in which professionals work to favor the well-being of the elderly; always, but from the PCA approach and from the evaluation and treatment within a clinical context.

Uninhibited behavior of the elderly person in relation to the Nursing Assistant

Psychopharmaceuticals such as antidepressants and benzodiazepines, which are usually prescribed in the aging stage to generally treat neurdegenerative diseases or dysthymic symptoms or symptoms of anxiety can alter sexual libido, sexual desire, or trigger sexual behavior disorders if the elderly person is not adequately monitored.

Uninhibited behavior refers to socially impertinent behaviors such as exhibitionism, immodest language and sexual intentions to the other without consent - decided unilaterally -. It may then be due to neuropsychiatric symptoms and / or coexisting with neurodegenerative symptoms.

In general, these behaviors tend to occur in the face of the Nursing Assistant, who is the professional who is physically and in the day-to-day with the elderly person residing in a center or in the SAD, the service to address. In both cases, it is important to know the person benefiting from the service well in order to offer the best possible well-being.

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Conclusion: Psychogerontologists and Assistants working together

Ultimately, the solution to the stigmatization of sexuality in older people and the lack of privacy lies above all in the work of the elderly. professionals, be they the assistants, psychogerontologists, nurses and assistants who are those who are in direct contact with people greater. This is why it is important to prevent (knowing neurodegenerative diseases), to know how to discern consent, advise and collect information and, above all, de-dramatize situations in which affectionate behaviors occur, as well as finding solutions to inappropriate behaviors, always from the Person-Centered Attention approach and from the evaluation within the clinical context.

Bibliographic references:

• Villar, F., Triadó, C., Celdrán, M., Fabà, J. (2017) Sexuality and Institutionalized Older People: the resident's perspective and the professional's perspective. Madrid: Pilares Foundation.