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Preserving Our Right to Sex in Long-Term Care

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Do you need to put your wishes in writing?

By Kevyn Burger

At age 74, Joan Price likes sex and doesn’t care who knows it.

“I plan to continue to celebrate the sexual pleasure my body can give me. Things may change and I will adapt to them, but I say, sex has no expiration date,” said Price, who calls herself an advocate for “ageless sexuality.”

While prevailing wisdom may suggest that the sex lives of 70-somethings are spoken of in the past tense, Price, a speaker, blogger and award-winning author (Naked at Our Age: Talking Out Loud About Senior Sex, Better Than I Ever Expected: Straight Talk About Sex After Sixty) has her future sex life on the brain.

Sex in Long-Term Care: Unfriendly Policies

Price worries that if she would ever live in senior housing — from assisted living to skilled nursing to hospice — her desire for sexual expression could be thwarted.

“Residents in long-term care get no privacy, so how can they explore their sexuality with another resident or solo when they can’t lock the door?” she said. In fact, many facilities’ policies are “archaic, regressive and even ageist,” according to a 2015 article in Time magazine.

One notable example, Time wrote, was at Hebrew Home at Riverdale (in the Bronx), which drew up a Sexual Expression Policy. Among other things, it “recognizes and supports the older adult’s right to engage in sexual activity, so long as there is consent among those involved.”

Price urges individuals to be frank in stating their intentions.

“It occurred to me that we need to put it in writing, while we are capable to give instructions to our spouses and grown children, about what we want when it comes to exercising our sexual rights,” she said.

‘Advance Directive’ for Sexual Expression

Price created a sort of advance directive to make clear her sexual wishes. It begins with her desire to live in a facility with a sex-positive environment.

“I want my rights respected — the right to close my door and have privacy, the right to have a relationship with someone of my choice or the right to charge my sex toys in my room and use them without being disturbed,” she said.

A few facilities that house aging residents are cautiously beginning to address their lifelong needs and desires as a body of research is emerging on the sexual activity of older adults.

Previously, sex researchers typically stopped quizzing subjects at the age of 60, since prevailing wisdom suggested people were no longer sexually active beyond that age.

Sexually Active Well Beyond 60

But a 2012 study in the American Journal of Medicine found that half the women surveyed (median age 67) remained sexually active, with sexual satisfaction increasing with age. A national survey in the UK became the first to ask people in their 70s and 80s about their sexuality and confirmed that half the men and a third of the women enjoyed active sex lives into their eighth and ninth decades.

“Many service providers for older adults have had their heads in the sand. They refused to acknowledge the sexual needs of their residents. But now the Centers for Disease Control is reporting a high number of sexually transmitted infections in this population, so we know they are active,” said Jane Fleishman, a Massachusetts-based sex educator involved in ongoing research into sexuality in aging adults. “Facilities need to think about a sex policy or directive for their residents’ safety as well as their pleasure.”

Fleishman, 63, regularly consults with older adult service and housing providers. She has noticed that the intimate needs of their clients are starting to be recognized by a small minority of them.

“Sexual well-being lowers depression, social isolation and cardiovascular disease. As lifespans increase, so will people’s ability to have new adventures and relationships later in life,” she added. “Facilities should be constructed so there are private spaces where adults can be their authentic selves.”

What to Do About Dementia

Being open about older adult sex is not without its complications. With the cognitive impairment that often accompanies aging, questions can arise about whether an individual is capable of giving consent, even if he or she had previously stated an intention to remain sexually active.

It’s a dilemma that can create liability fears for administrators who run senior housing facilities and are charged with making sure their residents aren’t mistreated or exploited.

“Adult children may have the expectation that their parents are not sexually active, and administrators have seen that there will be hell to pay if the wrong two people start getting it on under their roof,” Fleishman said. “But deciding if someone can provide consent should come in a clinical assessment. It’s a question for a geriatrician, not a family member.”

Professor Gayle Appel Doll, a gerontologist and director of the Center on Aging at Kansas State University, noted that an advance directive can’t anticipate how individuals might change with age and the onset of cognitive impairment.

“When people have dementia, we see changes in their libido leading to less interest in sex. But we also see personality changes that go the other way,” such as the straitlaced older woman “who now wants to kiss men who look like her husband,” said Doll, author of Sexuality & Long-Term Care: Understanding and Supporting the Needs of Older Adults.

Building for Privacy

In her research, Doll surveyed developers who build senior housing to see if they considered resident sexuality in their planning. She found few retirement or nursing home developers accommodating the privacy needs of future residents who want opportunities for intimacy or conjugal visits.

But Doll thinks that’s changing, due to demands of the boomers and new federal policies.

“Facilities are under pressure to let their residents make their own decisions,” she said. “Mandates coming from Medicaid and Medicare require a personal care plan that lets residents say what they want for their lives and gives more weight to their preferences.”

Doll suggests that adults speak frankly about their sexual intentions to those whom they name to carry out their stated instructions.

“Creating the elements of an advance directive gives you the opportunity to talk to the people close to you and let them know what you want. I recommend having a conversation about your sexual desires in a general way with someone who might be your durable power of attorney,” she said.

But Doll admits that she doesn’t practice what she preaches.

“This means you have to have that awkward conversation with your kids, because that’s who’s going to be in control of you. And talking about the sex life you think you will want as you age is not easy,” she said. “I’m 63, and have I talked to my two grown sons about this? No.”

Persistent Silence on Sex

The lack of communication about older adult sex underscores society’s deep discomfort with acknowledging the intimate needs of the aging population.

“Even those who work in the field can’t get over what I call the ‘ick’ factor, their disgust with even the idea of wrinkly people having interest in sex,” said Price. “I’d like to see us talk out loud about lifelong sexuality without embarrassment, guilt or shame.”

Even if they don’t choose to formalize their sexual desires in a written document, Price urged people to ask questions about sexual policies as they evaluate older adult living situations.

“This is going to be your home, not a prison, so it’s incumbent on you to explore which facilities would respect your privacy and which ones would take it away,” she said.

Complete Article HERE!

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10 tips for good sex in long-term relationships – for men and women

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Penguins play before mating.

By Isabel Losada

Make pleasure a priority

A happy and nourishing sex life (for both partners it’s necessary to emphasise) is good for your mental health and your physical health. Tender and loving intimacy is central to your well-being and so your family’s happiness and this impacts on – well, everything.

Don’t compare your sex life to the absurd but Oscar-winning performances of porn stars

Real sex isn’t like that.  Neither of you has to perform. If you make your body feel good and your partner’s body feel good and you’re both happy in the moment and the following day  – that’s good sex.  There is no way anyone can fail if you feel loved and nourished.

Don’t get stuck in a routine

The sensation that can be experienced in our bodies is as wonderful and varied as food can be. Hopefully you don’t always go to your local Indian restaurant and order the same vindaloo. If you do you’re missing out on all the more subtle and interesting flavours. Broaden your knowledge about how to please and be pleased.

Women:

You must be honest about the sensation in your body no matter how difficult it is for you to give honest feedback.  I know it’s annoying but men can’t read our minds and if we exaggerate the pleasure we say we feel we don’t help the men or ourselves.  Don’t go down that path.

Men:

A lot of what you are told about having to be ‘longer, harder, stronger’ etc is all nonsense designed to make you feel you need to buy products.  Ignore those spam emails but please do learn the art of stroking a clitoris – (details in the book.)

Learn about women’s arousal

Both partners have a responsibility to ensure that the woman has as much pleasure in bed as the man.  (Clue – it’s usually more complex and subtle) How can a woman really desire her partner unless she receives genuine pleasure from them?

Don’t think about other things when you’re in bed with the person you love

It’s rude! ‘Listen’ to the touch and the sensation in your body when you’re having sex.  Allow yourself to enjoy every second. If you find yourself thinking about other things – don’t be cross with yourself just go back to ‘listening’ to the sensation. Make relaxed time for pleasure.

Don’t have any goals

Women don’t chase orgasms and men don’t put pressure on a woman to orgasm. Sex is not a performance and orgasm is an involuntary state. Just breathe, explore all sensation and remove all pressure. The only aim is to enjoy. There is no way for either men or women to fail in bed. Breath. Touch. Laugh.

Women and men:  Make sure you know what your pelvic floor muscles are

They are the ones you use to ‘hold wee’. Exercise these muscles every day; you’ll never buy incontinence pads and it will improve your sex lives too. There is an app from the NHS called ‘Squeezy’ – use it. Five times a day. Thank me in six months.

Men:

Take the 21-day challenge of not ejaculating for that time, either during lovemaking or on your own. It’s an ancient tantric discipline. You’ll learn a lot about holding your own arousal level and being more aware of your partner’s. It leads to some great sensation and ultimately more connected and rewarding sex.

Complete Article HERE!

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Long-term sexual satisfaction: What’s the secret?

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Once the flutters of a new relationship are over, for many, the slog of everyday life sets in. But how do you keep the spark alive?

Sex is a key factor in most romantic relationships. In fact, earlier this year, Medical News Today reported that the “afterglow” that newlywed couples feel for up to 2 days after having sex is associated with greater marital satisfaction.

But last week, a new study showed that 34 percent of women and 15 percent of men who had lived with their partner for at least 1 year had lost interest in sex.

There are many factors that can affect sexual desire. Find out how much sex has the greatest effect on happiness, why some people lose interest, and what factors contribute to long-term sexual satisfaction.

How much sex is enough?

In a 2016 paper, Amy Muise, Ph.D. – a postdoctoral fellow in the Department of Psychology at the University of Toronto Mississauga in Canada – explains that there is plenty of evidence that “[…] the more sex people reported, the happier they felt.”

However, Dr. Muise also questions whether trying to have sex as “frequently as possible” is actually going to have the desired effect, particularly in light of the busy lives that many people lead.

Is the pressure of having frequent sex getting in the way of happiness?

Dr. Muise reports a clear relationship between the frequency of sex and happiness. What she found was that people who had sex once per week or more often were significantly happier than those who had sex less often.

But study participants who had sex on several occasions per week were not happier than those who had sex once each week.

The results were true for individuals who were in a romantic relationship, including women, older participants, and those in long-term relationships who tend to have less sex.

Interestingly, having sex had a greater effect on the participants’ happiness than income. So if sex makes us happy, why do so many people lose interest?

Who loses interest in sex?

There is plenty of evidence that being in a long-term relationship, being a woman, and increasing age are linked to a drop in sexual frequency.

Last year, MNT reported that women’s sexual desire decreased in long-term relationships. However, over the 7-year study period, the participants’ ability to reach orgasm improved – especially in those who had been in the same relationship the entire time.

So, for women, staying with a partner means better orgasms but less interest in sex, according to the research.

Last week, we reported on a new study published in BMJ Open that adds to the body of evidence showing that women’s interest in sex decreases in relationships.

Prof. Cynthia Graham, from the Centre for Sexual Health Research at the University of Southampton in the United Kingdom, found that more than 34 percent of women who had lived with their partner for at least 1 year lacked interest in sex, while only 15 percent of men did.

The biggest turn-offs

Prof. Graham identified a number of factors that were associated with the drop in sexual desire found in her study.

For women, these were having young children, having been pregnant in the past year, living with their partner, being in a longer relationship, not sharing the same level of sexual interest, and not sharing the same sexual preferences.

For both genders, health conditions (including depression), not feeling close to their partner during sex, being less happy with their relationship, and having sex less often than they were interested in all contributed to a drop in sexual interest.

Age was another factor. Men experienced the lowest levels of interest in sex between the ages of 35 and 44, while for women, this was between 55 and 64.

Julia Velten, Ph.D. – a postdoctoral fellow at the Mental Health Research and Treatment Center at Ruhr University Bochum in Germany – reported that when men felt that their partner expected them to always initiate sex, it had a negative effect on their sexual satisfaction.

Sexual desire discrepancy, which is the difference between the actual and desired frequency of sex, was a negative factor for both men and women.

Sexual function also played a role for the couples in Dr. Velten’s study. Men were affected by their partner’s lack of sexual function, such as lack of arousal, while women were more affected by the partner’s distress about their own sexual problem, such as erectile dysfunction.

How does masturbation fit into the picture?

On this topic, research findings do not agree. In a study involving couples living in Prague, Kateřina Klapilová, Ph.D. – from the Department of General Anthropology at Charles University in Prague – found that for women, masturbation negatively affected their sexual satisfaction.

But masturbation had no effect on men in these couples.

Meanwhile, Prof. Graham found that men who had recently masturbated were less interested in sex, while masturbation was not related to a change in women’s sex drive.

Prof. Graham told MNT that in her previous research, she had “found striking gender differences in factors associated with frequency of masturbation in men and women.”

She added that “when men were having less partnered sex, they tended to masturbate more often, whereas the reverse was true for women.”

With 51.7 percent of male and 17.8 percent of female participants reporting to have masturbated in the 7 days prior to study interviews, this is clearly a factor that is important in many relationships.

But just how masturbation contributes to or distracts from long-term sexual satisfaction remains to be seen.

With significant levels of both men and women reporting a drop in sexual interest and satisfaction, is there a secret to keeping the spark alive?

The secret to sexual satisfaction

Dr. Klapilová’s study found that for both men and women, penile-vaginal intercourse and the consistency of being able to reach vaginal orgasm were associated with sexual satisfaction.

She points to the “special role that vaginal orgasm (as distinct from other orgasm triggers) had in maintaining higher-quality intimate relationships.”

Anik Debrot, Ph.D. – alongside Dr. Muise and other colleagues from the University of Toronto Mississauga – recently studied the link between affection and sexual activity.

In her study paper, which was published this year in the journal Personality and Social Psychology Bulletin, she explains that “when engaging in sex, people not only seek an intimate connection, but indeed experience more affection, both when having sex and in the next several hours.”

“Thus, sex within romantic relationships provides a meaningful way for people to experience a strong connection with their partner,” she adds.

To her, this indicates that sex is important in romantic relationships because of the emotional benefits that we feel. Dr. Debrot suggests, “[When sex may be impaired], affection could help maintain well-being despite decreased sex frequency.”

The effect of time

A study by Prof. Julia Heiman, from the Department of Psychological & Brain Sciences at Indiana University in Bloomington, studied 1,000 couples in five countries (Brazil, Germany, Japan, Spain, and the United States).

Although the length of the couples’ relationships ranged from 1 to 51 years, half had been together for at least 25 years.

Prof. Heiman found that “[w]omen reported significantly more sexual satisfaction than men and men more relationship satisfaction.” In particular, “Men who valued their partner’s orgasm were more likely to report relationship happiness.”

Women’s sexual satisfaction increased from 40 percent at the start of the relationship to 86 percent once they had been with their partner for 40 years.

From these studies, penile-vaginal sex, affection, and the time spent in the relationship are key ingredients to a happy sex life. But there is one more factor that could be key: open communication.

Talking about sex

In Dr. Velten’s study, open communication about sexual wishes and frequencies had a positive effect on the quality of sex that the participants reported.

Likewise, participants in Prof. Graham’s study who found it easy to talk about sex with their partner were more interested in sex.

She told MNT that “[their] findings underline that open communication with a partner about sex is one of the most important things you can do to try to maintain sexual interest in a relationship.”

Sexual desires and preferences are, by nature, intrinsically personal and individual. Research in this field is complex, and while studies can show associations and trends, they will not be able to tease apart the reasons for an individual’s sexual satisfaction.

I don’t think that there is any ‘secret’ to long-term sexual satisfaction! Human sexuality is too diverse and ‘fluid’ for this to be the case – but […] open communication about sex with a partner should go some way to preventing sexual problems from developing.”

— Prof. Cynthia Graham

Talking about sex may be a good starting point. Finding a way to fit sex into the pressures of daily life may be challenging, but affection and time together might well help.

Complete Article HERE!

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Long-term relationships may reduce women’s sex drive

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Female sexual function is an important component of a woman’s sexual health and overall well-being. New research examines the relation between female sexual functioning and changes in relationship status over time.

Female sexual functioning is influenced by many factors, from a woman’s mental well-being to age, time, and relationship quality.

Studies show that sexual dysfunction is common among women, with approximately 40 million American women reporting sexual disorders.

A large study of American adults between the ages 18-59 suggests that women are more likely to experience sexual dysfunction than men, with a 43 percent and 31 percent likelihood, respectively.

Treatment options for sexual dysfunction in women have been shown to vary in effectiveness, and the causes of female sexual dysfunction still seem to be poorly understood.

New research sheds light on the temporal stability of female sexual functioning by looking at the relationship between various female sexual functions and relationship status over a long period of time.

Studying the link between relationship status and female sexual desire

Previous studies that examined sexual functions in women did not look at temporal stability and possible interactions between different female sexual functions.

But researchers from the University of Turku and Åbo Akademi University – both in Finland – looked at the evolution of female sexual desire over a period of 7 years.

The new study was led by Ph.D. candidate in psychology Annika Gunst, from the University of Turku, and the results were published in the Psychological Medicine science journal.

Researchers examined 2,173 premenopausal Finnish women from two large-scale data collections, one in 2006 and the other 7 years later, in 2013.

Scientists used the Female Sexual Function Index – a short questionnaire that measures specific areas of sexual functioning in women, such as sexual arousal, orgasm, sexual satisfaction, and the presence of pain during intercourse.

Researchers took into consideration the possible effects of age and relationship duration.

The average age of the participants at the first data collection was 25.5 years. Given that the mean age was quite low and the average age of menopause is much later, at 51 years, the researchers did not think it necessary to account for the possible effects of hormonal changes.

Relationship status influences sexual desire over time

Of the functions examined, women’s ability to orgasm was the most stable over the 7-year period, while sexual satisfaction was the most variable.

The ability to have an orgasm improved across all groups during the study, with single women experiencing the greatest improvement.

Women with a new partner had a slightly lower improvement in orgasmic ability than single women, but a higher improvement than women who had been in the same relationship over the 7-year period.

The study found that women who had stayed in the same monogamous relationship over the entire 7-year observation period experienced the greatest decrease in sexual desire.

By contrast, women who had found a new partner over the study duration experienced lower decreases in sexual desire.

Women who were single at the end of the observation period reported stable sexual desire.

According to the researchers, relationship-specific factors or partner-specific factors that have no connection with the duration of the relationship do have an impact on women’s sexual functions. Consequently, healthcare professionals should account for partner-specific factors when they treat sexual dysfunction in women.

However, researchers also point out that sexual function needs to be further examined in a short-term study to have a better understanding of the diversity in sexual function variation.

Strengths and limitations of the study

Researchers point out the methodological strengths of the study, as well as its limitations.

Firstly, because the study was longitudinal, it reduced the so-called recall bias, meaning that participants reported their own experience with higher accuracy.

The study also benefited from a large study sample, validated measures, and structural equation modeling, which reduces errors in measurement.

However, the authors note that the long 7-year timeframe may not account for short-term fluctuations, and varying sexual functions may interact differently when studied over a long period of time.

The study did not examine sexual dysfunctions.

Finally, the authors mention that they did not have access to data about cohabitation, or about the duration of singlehood.

Complete Article HERE!

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Gay couples more likely to have a happy sex life in long-term relationships compared to straight couples

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Same-sex couples are more likely to work on their sex lives

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Same-sex couples are more likely to have a happy sex life in long-term relationships compared to straight couples.

And not only are gay people more likely to work on and try new things in their sex life, they are also less likely to believe they are ‘destined’ to be with a perfect partner.

According to new research by the University of Toronto, both same-sex and opposite-sex couples were happier when they were willing to work on their sex life and did not believe in a ‘perfect mate’.

Jessica Maxwell, a PhD candidate in the Department of Psychology in the Faculty of Arts & Science, used research involving 1,900 participants of both gay and straight couples.

‘Gay and lesbians have higher levels of sexual growth beliefs than heterosexuals, and have lower levels of sexual destiny beliefs than heterosexuals,’ she told Gay Star News.

‘This is encouraging because those with higher sexual growth beliefs had the best outcomes in our studies!’

The better outcome meant higher relationship and sexual satisfaction.

Lesbian Bed Death2

‘We know that disagreements in the sexual domain are somewhat inevitable over time,’ Maxwell added. ‘Your sex life is like a garden, and it needs to be watered and nurtured to maintain it.’

Maxwell scored gay and lesbian couples on average of 6.02 versus straight couples of 5.68 on the question of whether couples believed in working on sex in a relationship.

And on whether people believed in ‘sexual destiny’, opposite-sex couples were far more likely with a score of 3.17 compared to 2.69.

‘The fact that same-sex couples are higher in sexual growth beliefs does suggest they have a healthier view of sexual relationships which should in turn foster greater relationship and sexual satisfaction over time,’ Maxwell added to GSN.

The way Maxwell worded the question on sexual orientation, it did not allow her to easily differentiate if there was a difference between gay male couples and lesbian couples.

However, while she did see women were more likely to believe in soulmates and romantic destinies, the researcher found they are more likely than men to believe sex takes work in a long-term relationship.

Maxwell hoped to show that problems in the bedroom are normal, and it does not automatically mean the relationship is in trouble.

The study, How Implicit Theories of Sexuality Shape Sexual and Relationship Well-Being, was published in the November issue of Journal of Personality and Social Psychology. The research builds on the work of other researchers (Bohns, Scholer and Rehman, 2015) who examined the belief sexual attraction can be malleable.

Complete Article HERE!

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