Age & Intimacy Sexual health and wellness of older people
AGE CONCERN | Serving the needs of older people
CONTENT S Kia Ora ........................................................................................ 1 The Rights of the Older Person ................................................... 2 Cultural Awareness ........................................................................ 3 Intimacy ....................................................................................... 4 Promoting Safe Sex and Intimacy ............................................... 5 Impacts of Age on Sex and Intimacy .......................................... 7 Sexual Orientation ........................................................................ 9 Resources ...................................................................................... 10 Reference List ........................................................................... 11
Acknowledgment We would like to acknowledge and thank Anika Paton and Kellie Hawkins, School of Occupational Therapy Year 3 Students for their professional approach and project management to help Age Concern Otago produce this valuable booklet on sexual health and wellness of older people in residential care. booklet on alternative transport options.
AGE CONCERN | Serving the needs of older people
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Kia Ora Age Concern Otago is pleased to provide you with information on sexual health and wellness of older people.
Sexuality doesn't stop with age. The older person is a sexual person, when one gets older the yearning for intimacy, security, and belonging becomes intensified. Some people struggle to acknowledge that older people are sexual beings with the same desires and rights as the rest of the population. This booklet while written for older people, can be a useful resource for family members and caregivers.
Some of the topics in this booklet may not directly affect you, but still be of interest. This booklet will not make you an expert, but it may be able to answer some questions that you have about this topic. To create this booklet a range of useful websites and research articles were found. These are referenced at the back of the booklet.
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AGE CONCERN | Serving the needs of older people
The Rights of the Older Person Everyone using a health and disability service is protected by the Code of Rights.
The rights of the older person are the:
1. Right to be treated with respect 2. Right to freedom from discrimination, coercion, harassment, and exploitation 3. Right to dignity and independence 4. Right to services of an appropriate standard 5. Right to effective communication 6. Right to be fully informed 7. Right to make an informed choice and give informed consent 8. Right to support 9. Rights in respect of teaching and research 10. Right to complain
These rights are put in place to protect and support your wellbeing while in residential care. This includes your right to meet your needs for intimacy when living in residential care, or receiving support from a caregiver.
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Cultural Awareness Cultural awareness is the ability to recognise your own values and beliefs and understand how these can influence your attitudes and behaviour.
Being culturally aware is important as it can impact partnerships and sexuality:
Understanding your partners values and beliefs is important as it ensures you both have an equal understanding of the expectations of the partnership
Cultural background can influence a person’s sexual behaviour and orientation
Everyone has different levels of intimacy that they engage in, and have different viewpoints on what intimacy entails, it is important to know your partners views and attitudes on intimacy.
In Aotearoa/New Zealand it is essential that your caregiver works in partnership with you and your whanau/family, protects your culture and customs, and ensures that you have an active role in your healthcare.
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AGE CONCERN | Serving the needs of older people
Intimacy Sexual intimacy provides warmth, closeness, touch, excitement, and wellbeing. It is important that you have the privacy and opportunity to be intimate with others and that carers support you to do so. Allowing for intimacy to occur between you and your partner(s) is very important for your well-being.
Ideas to promote intimacy with others:
Holding hands
Applying hand cream on self, or with others
Receiving hugs
Sitting down and having a conversation with another person
Ideas to promote more sexual intimacy and/or excitement:
Indulge your sensual side through dancing, eating food that excites your taste buds, or wearing clothes that make you feel sexy.
Discover your erotic side - watch a sexy movie or read an erotic book, join a new club or learn a new hobby that excites you.
AGE CONCERN | Serving the needs of older people
Promoting Safe Sex and Intimacy When engaging in unprotected sex you are at risk of getting a sexually transmitted infection (STI), and possible pregnancy for younger females.
If you experience any of the following you should seek medical advice: • Unusual discharge from the vagina • Discharge from the penis • Pain or burning when you pass urine • Itches, rashes, lumps or blisters around the genitals or anus • Pain and/or bleeding during sex • Bleeding after sex
If experiencing any of these signs or symptoms it is advised to see a health care professional or ring Healthline New Zealand for advice and information from a registered nurse.
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AGE CONCERN | Serving the needs of older people
Promoting Safe Sex and Intimacy continued Practicing safe sex reduces your risk of getting a sexually transmitted infection. There are a few options for reducing your risk of getting or spreading an STI:
Male condom
Female condom
Dental dam (for oral sex)
It is important to keep yourself safe when engaging in sexual activity. Practicing safe sex and getting checked regularly for STI’s is important. This can be done at the local GP or Family Planning. For more information on STI’s and safe sex options here are some useful resources:
New Zealand Sexual
NZ Healthline
New Zealand Family
Health Society
0800 611 116
Planning
ww.nzshs.org
www.familyplanning.org.nz
AGE CONCERN | Serving the needs of older people
Impact of Age on Sex and Intimacy
Many older people still engage in sexual intercourse, oral sex, and masturbation. As you age, sex and sexuality can be affected by both your own, or your partners physical changes. Menopause can impact on women’s sexual function:
Vaginal dryness
Heightened anxiety decreases blood flow to the vaginal area which can often result in discomfort during intercourse
Testosterone levels reduce in menopausal women. These decreased levels of testosterone can lead to a loss of sexual desire and drive, feelings of decreased physical well-being and persistent fatigue
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AGE CONCERN | Serving the needs of older people
Impact of Age on Sex and Intimacy continued Erectile dysfunction is very common - about 40% of men in New Zealand between the ages of 40-70 have some form of erectile dysfunction.
Common causes of erectile dysfunction can be due to pre-existing conditions such as vascular disease, excessive alcohol consumption, medication side effects and poor sexual techniques.
Ways to combat sexual dysfunction due to age:
Lubrication - this can reduce discomfort when engaging in penetrative sex and can increase stimulation
Medications can help with erectile dysfunctions and can increase women’s libido
For more information on sexual health visit:
NZ Sexual Health Society: Healthline NZ 0800 611 116
Sexual Health for all www.nashs.org
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Sexual Orientation Sexual orientation and gender identity make up only one part of who someone is and can change throughout a person's life. LGBT is an acronym that has been around for years and stands for lesbian, gay, bisexual and transgender.
Recommendations for people living alongside older adults who identify as either LGBT include:
Ensuring a safe, supportive and open environment for discussions to be had around sexual orientation.
Questions about sexual orientation and gender identity should be routinely asked of all patients or residents to provide thoughtful and culturally appropriate care to all older adults.
Ensuring the older person is identified on documents and notes by their identified gender rather than their biological gender.
New Relationships Some people choose to explore new aspects of their sexuality that they haven't in the past when they become single. For some this may involve having a relationship with someone of the same sex or with someone of the opposite sex for the first time. The world is a changing and more supportive place to be OUT and PROUD
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AGE CONCERN | Serving the needs of older people
Resources to Support Sexual Health and Wellness Age Concern New Zealand www.ageconcern.org 04 384 4349 Relationships Aotearoa www.relationships.org.nz New Zealand Sexual Health Society www.nzshs.org 0800 742 546 Healthline NZ 0800 611 116 – call for free advice and information from a trusted registered nurse New Zealand Family Planning www.familyplanning.org.nz
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References Ambler, D., Bieber, B., & Diamond, M. (2012). Sexual function in elderly women: a review of current literature. Reviews in Obstetrics & Gynecology, 5(1), 16-27. Doi: 10.3909/riog0156] Family Planning Association. (2010). People over 50 relationship and sexual health. London: UK Family Planning. (n.d.). Advice. Retrieved from www.familyplanning.org.nz Fong, E., Catagnus, R., Brodhead, T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behaviour Analyst. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC4788642/ Health and Disability Commissioner. (n.d.). The HDC Code of Health and Disability Services Consumers’ Rights Regulation 1996. Retrieved August 30, 2018, from www.hdc.org.nz/your-rights/about-thecode/code-of-health-and-disability-services-consumers-rights/ Jablonski, Vance, & Beattie. (2013). The invisible elderly: lesbian, gay. Bisexual, and transgender older adults. Journal of Gerontological Nursing, 39(11), 46-52. Doi: 10.3928/00989134-20130916-02 Ministry of Health. (2014). Treaty of Waitangi Principles. Retrieved from www.health.govt.nz/ourwork/populations/maori-health/he-korowai-oranga/strengthening-he-korowai-oranga/treatywaitangi-principles Murray, R. & Zentner, J. (2001). Health Promotion Strategies through the Life Span. Upper Saddle River, New Jersey: Prentice Hall Sexually transmitted diseases (STDs). (2018). Mayo Foundation for Medical Education and Research. Retrieved from www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseasesstds/symptoms-causes/syc-20351240 Sexually transmitted infections (STD). (2018). Planned Parenthood Federation of American Inc. Retrieved from www.plannedparenthood.org/learn/stds-hiv-safer-sex Sexually transmitted infections Education Foundation. (2017). Sexually Transmitted Infections: Summary of Guidelines [booklet]. Retrieved from www.nzshs.org/docman/guidelines/best-practiceguidelines/231-sexually-transmitted-infections-summary-of-guidelines-2017/file Waitemata District Health Board. (2010). Culture and Cultural Competence. Culturally Linguistically Diverse. Retrieved from www.caldresources.org.nz/public/courses/Culture-and-CulturalAwareness/resources/docs/CALDWorkbook.pdf
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AGE CONCERN | Serving the needs of older people
Notes
AGE CONCERN | Serving the needs of older people
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This booklet was compiled by Occupational Therapy Students
26 Bath Street, Dunedin 9016 PO Box 5355, Dunedin 9058
AGE CONCERN NEW ZEALAND 03 477 1040 agecon@ageconcernotago.co.nz ageconcernotago.com