Sex Ed--for Seniors?
By Allyson Roberts
After working for 30 years as director of staff development for a hospital in Connecticut,
Jane Fleishman decided that she had one more career in her. Fleishman, 58, a doctoral
student in Widener’s Center for Human Sexuality Studies, became interested in the
issues of sexuality and aging after a friend introduced her to Dr. Laura Singer-Magdoff,
a 95-year-old practicing psychotherapist. Fleishman soon began presenting sexuality
education lessons for the gray-haired set in Singer-Magdoff’s weekly discussion group
at her assisted living community in the Bronx, N.Y.
Fleishman, through qualitative research to gauge the effectiveness of her teaching, learned that two things are clear: First, people in their 70s, 80s, and 90s still think about and often pursue intimate relationships. Second, most older adults are thrilled to learn how the human sexual response affects them in their later years and to know that they can still experience tremendous pleasure. Many people who have forgone sexual activity due to health or cognitive changes are happy to learn ways to accommodate these changes, Fleishman said.
She found that there is a substantial lack of research in this area. "Most research related to sexuality and aging centers around problems related to sexual function, which creates a lopsided view and a stereotype that healthy older people aren't interested in sex," Fleishman said. "Without researching samples of healthy older adults, we can't develop or generalize models of sexual relationships later in life."
Filling that void of research and providing more education on a subject long viewed as off-limits is the goal of the Sexuality and Aging Consortium, an education outreach program of Widener's Center for Human Sexuality Studies.
The Consortium, founded in 2007 and integrated into Widener in 2010, is comprised of professionals nationwide who provide sexuality education, counseling, and resources for older adults, their families, and caregivers. Members also offer training, consulting, and policy development services to professionals serving older adults.
The program is the only one of its kind in the country, said Melanie Davis, current co-president of the Sexuality and Aging Consortium at Widener University. "No other organization exists that's quite like ours," she said.
Davis said that through conferences, training sessions, and media exposure, consortium members share their unique areas of expertise with each other and with other professionals interested in sexuality and aging. She hopes these efforts spark a shift in attitudes about sex and aging throughout the nation. "The Consortium's work is especially important as Baby Boomers age," Davis said. "These people grew up in a time when sexual freedom was glorified and the contraceptive pill was introduced. They're not giving up these freedoms now just because they're growing older, and they shouldn't have to."
Part of the Sexuality and Aging Consortium's work focuses on educating and counseling older adults directly so that they can enjoy life-affirming, safe sexual expression as they age despite both biological and cultural challenges that may get in their way. Davis said the challenges are varied, yet they are rarely broached by physicians or discussed between aging partners. "There are real challenges to being sexually expressive at a later age," Davis said, listing several examples like lowered sex drive due to hormonal changes, surgeries that may affect performance or the experience of pleasure, side effects from medication, the loss of a partner, or the notion that an aging body is unattractive. "Education can help older adults manage most of these challenges so they can enjoy being as sexually expressive as they want to be."
Davis said sexual expression, whether experienced alone or with a partner, has many benefits: "People who accept and enjoy their bodies sexually report a greater sense of self-esteem and well-being. Those who engage in sexual activity may enjoy increased circulation, better sleep, and even decreased pain from medical problems. Older adults with sexual partners may enjoy greater emotional intimacy and sexual satisfaction once they adapt to age-related changes and rethink their sexual scripts. The Consortium is eager to help make these positive changes possible."
Peggy Brick, 84, the founder and a past president of the Sexuality and Aging Consortium, said feelings of intimacy and desire do not have to end as one ages. "It's still appropriate for people at our age to be intimate. It's OK."
Brick has co-published two textbooks on the subject and regularly teaches a class known as "sex ed for seniors." She said the goal of her class is to get attendees to open up and rethink their sexual scripts, beliefs that paint a picture of what people who engage in intimate behavior look like and how intimacy unfolds in a methodical way, from a caress leading to a kiss and so on until intercourse occurs. "We need to give adults a broader definition of sexuality," she said. "We need to change the sexual scripts that we learned as kids, where the young are sexy and the focus is solely on sexual intercourse and orgasm."
Brick said forms of sexual intercourse are typically part of sexual relationships, but as couples age, the act may become harder to complete due to physiological changes. Men especially become frustrated and embarrassed that they can't perform as they once did in their youth, she said. "It's most often the men, not the women, who abandon their sex life and intimacy altogether as they age," she said. "We want them to continue to embrace their sexuality to enjoy healthy, happy, fulfilled lives, but awareness as to how to move forward is half the battle."
The Consortium is committed to educating caregivers on the intimacy rights and needs of seniors but struggles to make inroads into nursing homes and assisted living facilities. "A lot of facilities are reluctant to train their staff on these sexuality issues because they operate under the mindset that if they don't do anything, nobody will criticize them," Brick said. She explained that most facilities broach the subject only when a question arises among the staff about residents' relationships or the behavior of a specific resident.
Brick was approached by her own senior living facility when a male resident became involved with a female resident who had early onset dementia. Brick helped the administration develop a policy for reacting to such issues and held a training workshop for staff. "Facilities need policies that dictate a collective approach to dealing with issues such as this so that one staff person doesn't feel the pressure to make a decision," Brick said. "Furthermore, one staff person may handle the issue one way, while another may handle it another. There needs to be consistency."
Brick sees the sexuality education of older adults and the training of caregivers as equally important because as older adults look to fulfill their intimacy needs, their places of residence and caregivers will have to adjust. She's witnessed her peers at her senior living facility grow bolder after attending her lessons. One woman felt empowered to ask for a double bed for her husband who was suffering from Parkinson's disease and living away from her in a separate wing. "After lunch, she'd go in and lie with him; her husband said it was the best part of his day," Brick said. "How simple was that? People need to know that it's OK to ask for that, and residences need to know it's OK to say yes."