Category Archives: Aging

It’s not just about sex

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The basic human need of intimacy does not disappear as we age however in aged care planning it is mostly overlooked and often regarded as inappropriate.

by Annie Waddington-Feather

Couples in aged care facilities are being given little to no privacy in their intimate and sexual relationships, and it’s often the staff who prevent couples from having this intimacy.

A UK study involving residents, non-resident female spouses of residents with a dementia and 16 care staff, carried out last year, found feedback very different from the stereotypical assumption of older people not been sexual.

Carried out by a research team for the Older People’s Understandings of Sexuality (OPUS), some participants denied their sexuality, others expressed nostalgia for something they considered as belonging in the past, and some still expressed an openness to sex and intimacy.

More recently a New Zealand pilot study carried out by Associate Professor Mark Henrickson, from the School of Social Work, and School of Nursing senior lecturer Dr Catherine Cook explored attitudes to sexuality in aged residential care facilities.

They found the need for better understanding of the intimacy needs of older people and a significant number of staff, families and residents are managing complex situations without clear processes to protect residents’ rights and safety.

Intimacy in a care home setting is complicated. Issues include querying consent for someone who is in cognitive decline, staff managing adult children who deem their parent’s behaviour as wrong, and a lack of privacy for couples. Plus, there is a stereotype to overcome – for many sex and intimacy is associated with youth, not older people.

“We are a microcosm of an ageist culture,” says Australian expert Dr Catherine Barrett, Director, Celebrate Ageing.

Dr Barrett’s views go beyond a person’s sexuality and importance of sex, believing there should also be a focus on non-sexual physical intimacy. She highlights a study by the University of Queensland where babies were found to recover quicker if they are touched.

“We need to focus more broadly,” she says. “Some people have sexual relationships because they’re lacking skin on skin touch. Known as ‘skin hunger’ (also known as touch hunger) it is a need for physical human contact, and this can be mistaken as a need for sex.”

She cites one example of a male resident who behaved very inappropriately to any females in the room. “A massage therapist came once a week and he stopped doing what he was doing,” she says. While some residential homes do access sex workers, Dr Barret says in some cases it’s simply for a person to come over and cuddle.

Aged care advocate Anne Fairhall, whose husband of over 50 years is living with dementia and is in a care home says they both missed skin contact. And it wasn’t just between the two of them. “In an aged care home, everyone puts on rubber gloves,” she points out.

Ms Fairhall believes people living with dementia respond very well to love, affection and intimacy. “We’d gone from sleeping in one bed to sleeping in two different locations, and he asked me ‘do you still love me?’; he couldn’t comprehend why I’d put him in a home.” she says. “But it’s not just about holding his hand; it’s about having some privacy.”

“It’s also about eye contact, an arm around the shoulder and stroking his skin. It’s giving him the body language message I’m connecting with him,” says Ms Fairhall. “I’d go in later in the day, sit close to him at dinner and after he’d eaten, get him into his pyjamas, kiss, cuddle and put cheek to cheek.”

Just lying beside her husband is comforting. “Staff are surprised if they walk in and they are a bit embarrassed at first– less so now as they get to know you,” she says.

Dr Barret is calling for more training and education to be given. “We can’t point the finger and say ‘not good enough’ to aged care homes – we need to be asking how we can help,” she says.

To this end, through the OPAL (Older People And SexuaLity) Institute, Dr Barret has developed a set of tools and resources for service providers and organisations. This includes holding workshops and helping develop policies and procedures around sexuality and intimacy.

After attending one of the workshops, Victorian provider Cooinda is in the process of implementing a sexuality policy template.

“This is an important step forward in what we do and the care we give,” says April Betheras, community support, Cooinda. “We talk a lot about person centred care and we have ideas about sexuality and intimacy, but the big thing is being able to think about the whole picture. It’s about identifying with the person and having the conversation.”

She says there is more communication with residents about the subject now, but acknowledges not all residents want to participate. “While some feel that [sexual] part of their life has gone, there are other ways of being close,” says Ms Betheras. “A partner can participate in aspects of care. This is what keeps them close and feeling connected still.”

Training in sexuality and intimacy is also now compulsory for staff. “Staff feel confident in speaking about and dealing with issues. For instance if someone wants access to a sex worker, what would you do that? Who would you go to?,” says Ms Betheras. “LGBTI is also incorporated so we can consider all particular needs.”

Complete Article HERE!

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Senior citizens are having more sex and enjoying it more than younger people

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Those age 70 and up are having more sex and enjoying it more than younger people. But they don’t kiss and tell.

A study published in March in the Archives of Sexual Behavior noted a decline in sexual frequency among Americans of all ages. The sole exception: people over 70.

By Kevyn Burger

Gray-haired customers sometimes sidle up to Smitten Kitten owner Jennifer Pritchett and say with a smile, “Bet you don’t get someone my age in here often.”

The owner of the south Minneapolis adult store smiles right back. “And then I say, ‘Well, you’re wrong. We see people your age every day,’ ” said Pritchett.

Conventional wisdom holds that couples in their golden years prefer to limit their affection to holding hands, a peck on the cheek, maybe a little nighttime cuddle. But a growing body of research reveals that America’s seniors are plenty active between the sheets.

A study published in March in the Archives of Sexual Behavior noted a decline in sexual frequency among Americans of all ages. The sole exception: people over 70.

In the most recent survey for the study, which has been conducted since 1972, millennials and Gen X’ers showed a drop in the number of times they have sex per year, compared with previous years. But the baby boomers and their parents are having sex more often than their cohorts reported in the past.

The study and others like it seem to indicate that the quality — not just the quantity — of sex improves with age. The National Commission on Aging reported that the majority of the over-70 set find sex to be more emotionally and physically satisfying than when they were middle-aged.

Those conclusions are in line with a 2015 British study that found half of men and almost a third of women above 70 reported having sex at least twice a month. It was the first British study on sexual health to include octogenarians. It documented that a sizable minority of those in their 80s still masturbate and have sex.

Many people are, especially younger people.

“We see a consistent disbelief that older people are sexually active,” said Jim Firman, president and CEO of the National Council on Aging.

But Firman is adamant that those antiquated, ageist attitudes shouldn’t put a damper on the love lives of older Americans.

“We can’t let expectations of younger people control what we do,” he said. “Physical contact is a universal need and should be normalized and encouraged as part of aging. We should break those taboos or exceptions that say otherwise.”

Different, but ‘still hot’

Pritchett is all about breaking taboos.

In addition to its selection of vibrators, lubricants and videos, Smitten Kitten maintains a lending library. The books that fly off the shelves the fastest are about sex in later life.

“That’s kind of telling about how hungry people are for this information,” Pritchett said. “Sex ed in school is based around reproduction. When you’re older, family planning is not part of your sexuality. What’s left is pleasure.”

The most popular of the books on the store’s shelf were written by Joan Price, who bills herself as an “advocate for ageless sexuality.” Her bestsellers include “The Ultimate Guide to Sex After 50,” “Naked at Our Age: Talking Out Loud About Senior Sex” and “Better Than I Ever Expected: Straight Talk About Sex After Sixty.”

“My mission is to help people maintain or regain a satisfying sex life, with or without a partner” said Price, 73, who lives in California and regularly lectures, blogs and offers webinars on topics such as senior-friendly sex toys and satisfying sex without penetration.

Price said she got interested in creating content about sexuality for underserved seniors when, at 57, she met a man and “had the best sex of my life.” The longtime health and fitness writer couldn’t find any resources that reflected her experience, so she tackled the subject herself, becoming an erotic cheerleader for her cohorts.

“Sex has no expiration date, but things change — our bodies, our hormones, our relationships,” she said. “Expectations have to change. Responses are slower, we need more sensation, more stimulation to be aroused. We may have to redefine or reframe sex, but it can still be hot.”

Price, who’ll lead workshops at Smitten Kitten on June 4-5, preaches about the importance of communication between older partners.

Silenced by sex shaming

For Carol Watson, 67, flexibility is the key.

Still bawdy about her body, the Minneapolis woman is semiretired from her work at a nonprofit but retains a full-time interest in intimacy.

Starting when she went to college in 1967, she said, she’s “cut a wide swath.”

“That was the Summer of Love, the year birth control pills became readily available,” said the married mother of two adult children. “There was no AIDS, no Hep-C, nothing that couldn’t be solved with a shot of penicillin. We were the generation that could have sex without consequences — and we did. I’ve had many partners and no regrets.”

When her libido flagged a decade ago, Watson asked her doctor for an estrogen prescription for both a patch and cream.

“I’m happy sex is still part of my life. It keeps me young,” she said. “It’s stress relief, validation. It’s about joy.”

Describing herself as “on the far end of the bell curve,” Watson enjoys sex several times a week, within her marriage and with other partners, and said she has no plans to slow down.

“My mother died at 92 and Dad lived to be 96. I’m going to live to be 120 and I’m not willing to let sex fade into the distance.”

Watson’s frankness makes her a bit of an outlier.

While sex may be more common among older adults than younger ones, talking about senior sex still seems off limits. And that only perpetuates the myth that seniors have little interest in it.

“It’s still a sex-shaming society for older people and they internalize that,” said Pritchett. “It’s too bad because the shame keeps seniors in the dark. Old bodies are just as worthy of pleasure as young ones.”

Complete Article HERE!

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The nitty-gritty of middle-age sex

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‘It’s good to experiment’

By Alana Kirk

If you are drinking your morning coffee while reading this, then perhaps this article should come with a warning. There are going to be phrases that we tend not to discuss much in public such as vaginal dryness, loss of libido and erectile dysfunction. However, they are a natural part of life, and if we want to continue to be active sexual people well into middle age and beyond, then we have to acknowledge and then address them, because turning the trials and tribulations of middle-age sex into the joy of sex is not difficult.

Sex is important to all of us, regardless of age. Not only is it excellent for getting the blood pumping and putting a youthful spring in your step, it has a number of other benefits too, such as reducing stress, strengthening your immune system, boosting self-esteem, and relieving depression.

The famous manual, The Joy of Sex, still has some salient advice for middle- aged and older people even though it was written nearly 50 years ago. It’s author Alex Comfort wrote: “The things that stop you enjoying sex in an old age are the same things that stop you from riding a bicycle – bad health, thinking it’s silly and no bicycle”.

Well, we can pump up a flat tyre, add some lubricating oil, and still be having sexual enjoyment with no partner. As recent research has shown, and despite an ageist societal view on the topic, our sexuality doesn’t die with middle and growing age. Our sexual needs and levels evolve and change over the years, and the particular issues that might arise from menopause, for example, do not mean we should give up on it. We just need to learn to adapt.

Emily Power Smith may be Ireland’s only clinical sexologist, and talks to large numbers of middle-aged women in her clinics and at talks around the country. “I’ve spoken and written more on this topic than any other related to sex, and the main driver for women coming to me with an issue is poor education. Generally women are very misinformed about what they should be expecting and are very quick to blame themselves.”

If we look at sexual activity as a life-long issue, there can be plenty of interruptions to the normal flow, including illness, childbirth and child rearing, loss of confidence, menopause, and hormonal fluctuations. Low libido, erectile dysfunction, and vaginal dryness are all just normal challenges that can affect our sexual lives, but importantly, ones that can be easily addressed.

“We do specific menopause consultations and counselling for women who start experiencing changes and want to know that they are a normal part of the ageing process,” says Dr Shirley McQuade, medical director of the Dublin Well Woman Centre. “Many women come in with a specific symptom thinking it’s all over, but in fact nearly all issues can be addressed. You just need to realise that your, and your partner’s body changes.”

So what are the main issues and what can be done about them?

Peri-menopausal symptoms

Menopause can effect every aspect of your being, and symptoms including hot flushes, not sleeping, and poor concentration levels, can affect how you feel about yourself.

“Hormonal changes can mean your libido and sex drive go, as well and the emotional havoc they can play,” explains Dr McQuaid. Mood swings, empty nest syndrome, trying teenagers, or work/life balance can weigh in to make us feel less than energetic about sex.

“It is really important to take the time for yourself when you are peri-menopausal, to take stock and adjust to the changes that are happening. I see lots of women who have reached senior career level or have lots of people depend on them and it can be difficult because they feel overwhelmed and aren’t giving enough time to themselves to deal with how they feel.”

The advice is to take pressure off yourself, and try and cull some of the responsibilities. Exercise, eat and sleep well and acknowledge that you can seek help if you need it. “I’ve seen women go to cardiologists because they think they have heart problems when they wake up sweating in the night, or go to rheumatologists with joint pain, when in fact they are just the symptoms of hormonal change.”

Hormone Replacement Therapy

HRT is a common treatment for women who are suffering from continued and difficult symptoms, and it only takes two or three weeks to find out if it will work for you. According to the National Institute for Health and Care Excellence (NicE) in their 2015 recommendations, the benefits of HRT, available in tablet form, gels, and patches far outweigh any risks.

According to Dr McQuaid, it is a positive option to take. “About 15 years ago there were scares about risks relating to heart disease and cancer, but the studies were seriously flawed. For women who take it through their 50s, the benefits are significant.”

HRT is available for as long as your symptoms last, with the average duration being eight years. Despite scaremongering to the contrary, there are no withdrawal symptoms or problems when you stop taking the drug, as long as you leave it long enough for your natural menopause to conclude. HRT masks the symptoms, so if you stop before they have fully receded, they will return.

Not all women experience menopausal symptoms, and for women who do, they do eventually pass.

Vaginal dryness

It is completely normal for most women in menopause to experience dryness. The drop in your body’s oestrogen levels means the vaginal membranes become thinner and drier which can makes for uncomfortable dryness. As a result, thrush and Urinary Tract Infections (UTI) are also more common. Lubrication is widely available and will transform your sexual experience if dryness is a problem. Dr McQuaid also recommends treating the underlying issue rather than just the symptom. A prescription product, licensed in Ireland as Vagifem, provides low levels of oestrogen to the local area, and if taken over the longer term can alleviate all symptoms of dryness. Regular sexual activity or stimulation from masturbation also promotes vaginal health and blood flow.

Erectile dysfunction

For men who may identify their every maleness with work and sexual ability, a lowering of libido or erectile dysfunction can be catastrophic. However, accepting that this will happen occasionally, and seeing it a normal part of the ageing process and hormonal changes may encourage them to seek help. The advice is to go to your GP to get checked out to make sure erectile dysfunction is not related to vascular changes and bold pressure / diabetes, and then again there is a simple medication solution.

Painful intercourse

Again this can be a common change in sexual experience, usually due to vaginal dryness. However, other reasons could be a prolapse of the uterus or front wall of vagina which can cause discomfort, so the first port of call for any pain is to get examined by your GP or at the Well Women clinics. All issues can be addressed with medication or procedures.

Heavy periods

A common complaint for women entering peri-menopause is very heavy periods, which are caused by the womb being uncomfortable and bulky. Some women from the age of 40 develop fibroids which make the womb heavier and along with hormonal fluctuations, combine to make structural and hormonal changes that affect the flow of periods. Some women have low iron levels, because heavy periods are the main reason for low iron which makes you tired, so it’s important to keep a medical check on your body while going through the menopause.

Traditionally this was often treated by a hysterectomy, whereas today women can access the pill or coil. All countries where the coil has been introduced have seen a significant reduction in hysterectomy operations.

Change of mind

Addressing specific symptoms is only one way of evolving our sexual lives. Changing the way we have sex is another. “I meet women who have only ever used one position, and now that that proves painful they are at a loss,” explains Dr McQuaid. “It’s useful to experiment and change. It’s more interesting too!”

What we need to remember is that sex is not just about intercourse. There is a variety of sensual, loving, exciting activities that can bring joy and satisfaction. For women experiencing menopause especially, they might need and want more touching and foreplay than before, but after years of marriage, it can be more difficult to change. Asking for what you need is important. Tantric sex – slightly ridiculed in the press after Sting and Trudie Styler admitted to it – is encouraged by many counsellors as it focuses on the sensual intimacy rather than an orgasmic goal.

Whatever the issue with sex may be, Dr McQuaid advises you start with a medical to check to make sure everything is okay. Once that is done, it’s just about dealing with specific issues. “I’ve had a 78-year-old woman come to me recently having a little bit of trouble because her partner has been given Viagra. So she went on Vagifem and has no more problems,” says McQuaid. “I have lots of women come to us for help and they’re happy and healthy and they certainly don’t stop having a sex life. Nor should they.”

Psychologically however, it is also important to rise above the social conditioning that we lose our sexiness as we get older. “There is just no scientific evidence to back this up,” explains Power Smith. “Irish women are very quick to blame themselves and feel guilty for not being better, not feeling enough or good enough. In part we are brought up to feel this way with magazines and media, and then when middle age hits, physical things happen to compound that.” She has three golden rules for women in their middle age with regards to keeping their sex lives healthy and functioning: masturbation, lubrication and communication.

So while the number of potential causes of sexual changes and challenges during menopause and middle ageing can seem overwhelming, there are just as many strategies and treatments for overcoming them.

You can go back to drinking your coffee now.

Complete Article HERE!

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Jane Fonda’s frank sex toy talk opens the door for a generation

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By Heidi Stevens

Seventy-nine-year-old Jane Fonda is doing for vibrators what 44-year-old Jane Fonda did for aerobics videos: mainstreaming them.

And not a moment too soon.

The new season of her critically acclaimed Netflix series, “Grace and Frankie,” co-starring Lily Tomlin, sees the two women launch a business selling sex toys for women. If you happen to drive down Vine Street in Hollywood, you might see a giant billboard of Fonda and Tomlin holding ribbed, purple objects under the words “Good vibes” — in case there was any confusion about what they’re holding.

And if you watch “The Ellen DeGeneres Show,” you may have happened upon Fonda unveiling a vibrator on daytime TV. (Take that, “The View”!)

“Use it or lose it, right?” Fonda says to DeGeneres, who seems uncharacteristically bewildered.

“Was this something you knew about before the character?” DeGeneres asks. “Before you researched it, was this something you knew about, I mean, were familiar with? Used?”

Fonda offers an emphatic “yes,” before explaining that she owns one vibrator that doubles as a necklace. “It looks like a beautiful piece of silver jewelry.”

Until it doesn’t.

“I applaud her,” said Lauren Streicher, medical director of Northwestern Memorial Hospital’s Center for Sexual Medicine and Menopause. “I’ve been trying to talk about this on daytime TV for years, and no one will have any part of it.”

Fifty-two percent of American women use a vibrator, Streicher said, according to a 2009 study published in the Journal of Sexual Medicine. And women over 60, in particular, need to know about their benefits.

“Sometimes nerve endings aren’t as sensitive as they used to be, so what did it for you before isn’t going to necessarily do it anymore,” said Streicher, who wrote “Sex Rx: Hormones, Health, and Your Best Sex Ever” (Dey St.). “In addition, you have a lot of medical conditions — diabetes, cardiovascular disease, multiple sclerosis — that can cause a desensitization of nerve endings, so there is a need for increased stimulation.”

Which may explain why the Carol Wright Gifts catalog — known mostly for its compression support knee-high socks, bunion bandages and denture liners — features a two-page spread of “personal massagers” with such names as Couple’s Raging Bull and The Amazing Butterfly Kiss.

There should be no shame in the vibrator game.

“It’s really just an acknowledgment that women are entitled to pleasure,” Streicher said. “It’s OK for men to have sex and pleasure and to desire that until the day they die, but when you look at women in their 70s talking about sexuality, that’s been something mainstream media has absolutely no interest in.”

Maybe Fonda will help change that.

“I hope so,” Streicher told me. “When I teach medical students, I tell them: Don’t ever say to a woman, ‘Do you have a vibrator?’ That is the wrong question. What you say is, ‘When you use your vibrator …'”

She continued: “When I ask a patient, as part of her history, ‘Are you able to have an orgasm?’ and she says no, I say, ‘How about when you use your vibrator?'”

It lessens the stigma and leads to a more honest discussion, Streicher said.

“We know, at best, maybe 25 percent of women are able to have an orgasm through intercourse alone,” she said. “If men weren’t able to have orgasms and there was a device that made it happen, there would be nothing taboo about it.”

And if Fonda has her way, there won’t be for much longer.

Complete Article HERE!

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It’s time to end the taboo of sex and intimacy in care homes

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By

Imagine living in an aged care home. Now imagine your needs for touch and intimacy being overlooked. More than 500,000 individuals aged 65+ (double the population of Cardiff) live in care homes in Britain. Many could be missing out on needs and rights concerning intimacy and sexual activity because they appear to be “designed out” of policy and practice. The situation can be doubly complicated for lesbian, gay, bisexual or trans individuals who can feel obliged to go “back into the closet” and hide their identity when they enter care.

Little is known about intimacy and sexuality in this sub-sector of care. Residents are often assumed to be prudish and “past it”. Yet neglecting such needs can affect self-esteem and mental health.

A study by a research team for Older People’s Understandings of Sexuality (OPUS), based in Northwest England, involved residents, non-resident female spouses of residents with a dementia and 16 care staff. The study found individuals’ accounts more diverse and complicated than stereotypes of older people as asexual. Some study participants denied their sexuality. Others expressed nostalgia for something they considered as belonging in the past. Yet others still expressed an openness to sex and intimacy given the right conditions.

Insights

The most common story among study participants reflected the idea that older residents have moved past a life that features or is deserving of sex and intimacy. One male resident, aged 79, declared: “Nobody talks about it”. However, an 80-year-old female resident considered that some women residents might wish to continue sexual activity with the right person.

For spouses, cuddling and affection figured as basic human needs and could eclipse needs for sex. One spouse spoke about the importance of touch and holding hands to remind her partner that he was still loved and valued. Such gestures were vital in sustaining a relationship with a partner who had changed because of a dementia.

Care staff underlined the need for training to help them to assist residents meet their sexual and intimacy needs. Staff highlighted grey areas of consent within long-term relationships where one or both partners showed declining capacity. They also spoke about how expressions of sexuality posed ethical and legal dilemmas. For example, individuals affected by a dementia can project feelings towards another or receive such attention inappropriately. The challenge was to balance safeguarding welfare with individual needs and desires.

Some problems were literally built into care home environments and delivery of care. Most care homes consist of single rooms and provide few opportunities for people to sit together. A “no locked door” policy in one home caused one spouse to describe the situation as, “like living in a goldfish bowl”.

But not all accounts were problematic. Care staff wished to support the expression of sex, sexuality and intimacy needs but felt constrained by the need to safeguard. One manager described how their home managed this issue by placing curtains behind the frosted glass window in one room. This enabled a couple to enjoy each other’s company with privacy. Such simple changes suggest a more measured approach to safeguarding (not driven by anxiety over residents’ sexuality), which could ensure the privacy needed for intimacy.

Conclusions

Our study revealed a lack of awareness by staff of the need to meet sexuality and intimacy needs. Service providers need guidance on such needs and should provide it to staff. The information is out there and they can get the advice they need from the Care Quality Commission, Independent Longevity Centre, Local Government Association and the Royal College of Nursing.

Policies and practices should recognise resident diversity and avoid treating everyone the same. This approach risks reinforcing inequality and doesn’t meet the range of needs of very different residents. The views of black, working-class and LGBT individuals are commonly absent from research on ageing sexuality and service provision. One care worker spoke of how her home’s sexuality policy (a rare occurrence anyway) was effectively a “heterosexuality policy”. It may be harder for an older, working-class, black, female or trans-identified individual to express their sexuality needs compared to an older white, middle-class, heterosexual male.

Care homes need to provide awareness-raising events for staff and service users on this topic. These events should address stereotyping and ways of achieving a balance between enabling choices, desires, rights and safeguarding. There is also a need for nationally recognised training resources on these issues.

Older people should not be denied basic human rights. This policy vacuum could be so easily addressed over time and with appropriate training. What we need now is a bigger conversation about sex and intimacy in later life and what we can do to help bring about some simple changes in the care home system.

Complete Article HERE!

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