The long goodbye.

 

          As I sit and contemplate my attitude about sexuality and aging for this week's post, I thought of Hattie's interview. I find myself admiring her authenticity and refusal to fit into a societal stereotype of an older woman. Her choices are far from my own, but her honesty on the subject makes me reevaluate why are we all so afraid to be a little more like her. 

The following is an assessment tool used to evaluate my attitude on sexuality and aging:

Personal Attitude Towards Sexuality and Aging?

What do I believe about sexuality and aging?

           I can say that I may have held the misconception that sexual desire and activity belonged to the young. Much like many things in life, the perspective of age has changed my viewpoint. I realize that the need to be loved does not extinguish with additional candles on a cake. I do find it "sweet" when I see an elderly couple showing affection in public. I imagine the life they have had, and all of the adventures shared. I think of all of the odds they have beat to find one another. 

What do I believe about the nurse's role concerning the sexual function of older adults?

           Working as a cardiac nurse, the sexual function has to be addressed with the majority of patients before discharge. Many patients face fears of resuming intimacy with their partners after suffering from a cardiac issue. As we already assess fro domestic and sexual abuse, a proper assessment must include a patient's sexual function and interventions offered to allow for a better functionality if needed. Living so close to the Villages and seeing the numbers of documented sexually diagnosed diseases, it is evident to me that safe sex practices need to be addressed. These conversations typically lead to some revealing and humorous conversations. Although these conversations are essential, I have found that in the acute care setting, finding the appropriate timing can be difficult.   

What is my attitude about various expressions of sexual activity?

           I am a believer that we all deserve love and companionship. I actively try to facilitate resources to allow a patient's partner to stay in the room with the patient. I believe this reduces anxiety and can increase receptiveness to learning. I feel that I am entirely open to all relationships that are respectful and loving of each other. I do struggle when I witness turbulent relationships, and when I hear people express views of intolerance. I try to have discussions that elevate the situations instead of alienating them, but this can be difficult at times with the added pressures of the hospital setting. My unit recently had to address care that was being provided for a transgender patient, and education was required for the nursing assistant that was providing surgical prep. I found it disheartening to hear the comments from healthcare providers and believe that we can do better as a whole.  

What are my attitudes about sexuality in long term care facilities?

           I struggle with this idea because I want to ensure sexual acts are consensual and between two willing partners that are of sound mind. This being said, if both people are fulfilling these requirements, then I see no reason why they cannot safely pursue a sexual relationship. Masturbation is a natural thing that I believe all adults participate in, but I think that it should be done in private. I would not have a problem ensuring people the time and safe space to allow for these acts. Ensuring the safety and wellbeing of our patients is fundamental. I believe for liability and the protection of patients, the relationship should be monitored in an assisted living facility with the knowledge of administrators. Intervention should occur swiftly if there is a decline in the physical or mental abilities of either person.  

What have I learned? What will I change?

             I learned that I should embrace my inner Hattie and discuss sexuality with more openness and honesty. Treating a whole person requires that sexual function and safety be included. A 2016 study that looked at sexual activity in adults aged 50-89 showed that increased sexual activity is associated with higher scores on tests of memory and executive function ( Wright & Jenks, 2016). 

Reference

Wright, H., & Jenks, R. A. (2016). Sex on the brain! Associations between sexual activity and cognitive function in older age. Age And Ageing, 45(2), 313–317.