Sexuality in the Elderly and the Role of Nursing Homes in Managing Sexual Desire

Employees who encounter the elderly must understand that love, desire, and sexuality do not cease due to age. Sexuality is a natural and essential part of people's lives, including the elderly. Despite this, the subject has often been taboo, especially concerning the elderly and within nursing homes. It is high time to change this and understand the importance of managing sexual desire among the residents in a respectful and empathetic way.

Sexual Desire and Well-being in the Elderly

Sexual desire can be present and meaningful throughout life, including old age. Many older people continue to have sexual needs and interests. Sexual activity can be beneficial for physical health by promoting movement, reducing stress, and improving mood. It can also strengthen relationships and enhance the quality of life.

Taboos Surrounding Sexuality in the Elderly

Several factors have contributed to the taboo surrounding sexuality in the elderly:
Age Discrimination: Society tends to associate sexuality with youth, which can lead to the sexual needs of the elderly being ignored or denied.
Institutional Limitations: Nursing homes and healthcare facilities have sometimes deprioritized sexual health and not provided appropriate opportunities for sexual intimacy.
Lack of Education: Many staff lack training and resources to handle sexual desire in the elderly, which can lead to older people feeling overlooked or ashamed.

The Role of Nursing Homes in Managing Sexual Desire

Nursing homes play a crucial role in promoting a healthy and positive view of sexuality among residents:
Education and Training: Staff should be trained in the sexual health of the elderly and how to handle sexual issues sensitively. This can include being aware of how medications can affect sexual desire and ability.
Privacy and Confidentiality: It is crucial to respect the privacy and confidentiality of the elderly concerning sexual issues. Discussions should be private and confidential.
Creating Safe Spaces: The nursing home should provide safe spaces where residents can practice sexual intimacy if they wish. This may include opportunities for couples to have private moments.
Supporting Relationships: Encouraging and supporting relationships among residents is important. This may involve enabling couples to live together or helping single elderly people meet new friends.
Communication: Staff should foster open and empathetic communication with the elderly. This involves listening to their needs and desires in terms of sexual intimacy.
Medical Factors: It's important to understand how medical conditions and medications can affect sexual desire and function. Where possible, alternative treatments should be considered.

Occasionally, residents behave inappropriately and touch the care staff. This is not acceptable. It is important to set boundaries. Often, it might be enough for the responsible nurse to have a conversation with the resident in question. In the case of people with dementia, the group may need to discuss and figure out the best solution. This becomes especially important if other residents are subjected to unwanted advances.

Another situation that can arise is that people living in a facility become attracted to each other without being married. Perhaps one of them has a spouse who does not live in the facility.

Some treatments can also affect sexuality. Many medications can cause erection problems like antidepressant treatment, blood pressure medications, and drugs that lower blood cholesterol. Diapers can be limiting, and urinary catheters can cause a lot of trouble for some men. They may cut off the tube repeatedly or try to pull it out. Older women may need estrogen treatment for fragile mucous membranes.

Sexuality in the elderly is an important and natural aspect of their lives. Managing sexual desire among residents in nursing homes is part of promoting their well-being and quality of life. By addressing taboos and providing support and resources, nursing homes can help older people continue to enjoy a healthy and meaningful sexual dimension in their lives. It's about respecting their right to sexual self-determination and integrity, regardless of age. Many elderly people who desire sex still abstain. Lack of a partner, lack of desire for the existing partner, or pain can be reasons. Likewise, the prejudices of their own adult children or the community can hinder. Many of those who are older today grew up in a society where sexuality is taboo. Staff who do not knock on the door before entering the apartment can also be a hindering factor.

Reflection Questions - Sexuality
Care Staff:
- Do you discuss the elderly and sexuality in the group?
- How do you handle situations where sexuality is involved in the unit?
- Have you discussed attitudes towards homosexuality or transsexuality in the group?

Manager, Nurse, Occupational Therapist, and Physiotherapist:
- Have you discussed the elderly and their sexuality in the group?
- Do you have residents whose sexuality has affected the unit?
- Do you have a common set of values regarding the sexuality of the elderly?
- How do you act if you get a resident with dementia who is sexually acting out?

Residents and Relatives:
- What are your thoughts on aging and sexuality?

Erland Olsson
Specialist Nurse
Sofrosyne - Better Care Every Day