Sexuality in Aging: Older people also have sexual relations.

Elderly people retain their libido, but have difficulty expressing it.

Recently, Feliciano Villar, Carme Triadó and Carme Triadó have recently discussed Sexuality in the elderly in their latest research Feliciano Villar, Carme Triadó, Montse Celdrán and Josep Fabà; Psychogerontologists with extensive training and experience. They refer to the perspective of the institutionalized elderly person, but also to the perspective of the professional.

It is clear, on the one hand, that many drugs that treat neurodegenerative diseases in the third and fourth ages cause as a side effect behaviors related to hyper-sexuality and/or sexual behavior disorders that are so complicated to treat or redirect for a health care professional. In fact, the disinhibited behavior of the elderly person in relation to the Auxiliary is common.

This is why this article deals with sexuality in agingIt is very important to know well the Sexuality in Aging in order to treat the elderly from the Person Centered Care and to offer the best possible quality of life.

Sexuality in aging

It is a reality that almost all people, from birth to death have sexuality, as well as the need to have sexual relations with others and alone. Consequently, it is also a reality that nowadays, in residential centers, there is a very relevant lack of sexuality. in residential centers there is a very relevant lack of intimacy. as well as individualized monitoring of the elderly due to lack of resources, professionals and, above all, training and communication.

In fact, as Villar, F., Triadó, C., Celdrán, M., Fabà, J. (2017) say, after having interviewed elderly residents and professionals, some of them comment that there are professionals who tend to have negative and very pejorative reactions to elderly people expressing their affective-sexual needs both in public and in private; in general we do not react naturally neither elderly people nor professionals, precisely because there is a clear stigmatization of the third and fourth ages, as well as ageism (age discrimination). (ageism).

What are the sexual needs in aging?

According to the elderly participants in the research and according to the professionals, in this case 83 out of 100, they explain that sexual needs are maintained during the aging process, although not completely.. However, some particularly consider that "interest is maintained but practice declines", and the intensity of sexual needs decreases but does not disappear.

In any case, sexual needs in Aging, as in the Adult Stage, will depend mainly on the Life History, as well as on the vulnerability to certain neurodegenerative and/or neuropsychiatric diseases, since sexual desire is closely related to these diseases, which are also so frequent. This set, then, must be reviewed by a social-health professional, in this case the Psychogerontologist either in Residential Centers or in Home Care Startups; with the aim of preserving in the best possible way the person's privacy and facilitating sexual expression since there are, according to the authors, two barriers on which it is necessary to work:

Internal Barriers

Shame and embarrassment about sexuality in old age The greatest ageism that exists, the greatest esteem, the greatest internal barrier to sexuality in old age, are modesty and feelings of shame. We are talking about moral rules and generational factors such as repressive education.

External Barriers

The context in the Residential Centers as well as the context at home and the infrastructure of the space in which the elderly person is located is the main external barrier. In Residential Centers, due to lack of resources, they usually live together in shared spaces. with a clear lack of intimacy and in the home, infantilization and overprotection are frequent. In this case, in the Centers the individual rooms would be a Facilitator and in the Home it would be an adequate clinical evaluation of the elderly person as well as of his/her context.

Barriers and facilitators for the expression of libido.

What can we professionals do about this? According to Villar, F., et al. "When asked about the most frequent sexual behaviors among residents, most of those who respond (many residents do not, as they consider this dimension to be absent in institutions), masturbation is the most frequently mentioned. Virtually all professionals mention this type of behavior, which in many cases they have unwittingly witnessed." So, what are the objectives and strategies to be followed?

1. In relation to the elderly

To know first hand their life history as well as to assess and treat assessing and treating their neurodegenerative diseases and to study the possible side effects of their psychopharmacological treatment.

2. In relation to the context

Due to the lack of resources, it is difficult to have single rooms in the Residential Centers, so that the best option is to ensure that the patient's the best option is to delay and/or avoid admission to these centers by means of new startups with the help of new home care startups.

3. In relation to the entire professional staff

Encourage continuous communication between nursing assistants and psychogerontologists in order to provide the best possible care for the elderly. to offer in the best possible way a person-centered care.. Counseling, moreover, is one of the main characteristic functions of social-health professionals of the third and fourth age.

Sexuality and dementia: 3 points to keep in mind

When dementia and sexuality overlap, the following points should be taken into account.

1. Discern consent

Nursing Assistants with more than one patient in their care are often faced with situations in which they do not know how to handle the situation. Of course, a sexual relationship between two people with dementia or in a couple where one of the partners has a neurodegenerative disease creates a lot of uncertainty, so it is difficult to know how to discern the consent of the older person. This is why Prevention and Follow-up carried out by Psychogerontology is so important.This is why Prevention and Follow-up carried out between Psychogerontologists and Assistants in a horizontal way is important in order to find a solution through ACP.

2. Counseling and gathering information

Sometimes, the reactions of professionals such as Nursing Assistants, Social Workers, Nurses, Psychogerontologists, etc., and/or family members are not correct, and therefore, Infantilization may occur. Infantilization may occur.. This is why it is essential to remain informed and to promote communication between professionals in order to advise and gather information from the different parties involved.

3. De-dramatize

De-dramatize and avoid uninhibited behavior on the part of the elderly personThe key for professionals to work to promote the well-being of the elderly, if any, is always, however, from the ACP approach and from the assessment and treatment within a clinical context.

Disinhibited behavior of the elderly person in relation to the nursing assistant.

Psychopharmaceuticals such as antidepressants and benzodiazepines, which are often prescribed in the aging stage to treat generally neurodegenerative diseases or dysthymic symptoms or anxiety symptoms may alter sexual libido, sexual desire or trigger sexual behavior disorders. if the older adult is not adequately monitored.

Disinhibited behavior refers to socially impertinent behaviors such as exhibitionism, lewd language, and sexual intentions to others without consent. and sexual intentions to the other without consent - decided unilaterally -. It may then be due to neuropsychiatric symptomatology and/or coexisting with neurodegenerative symptomatology.

In general, such behaviors usually occur in the face of the Nursing Assistant who is the professional who is physically and on a day-to-day basis with the elderly resident in a center or in the SAD, the home service. In both cases, it is important to know the beneficiary of the service well in order to offer the greatest possible well-being.

Conclusion: Psychogerontologists and Assistants working hand in hand

In short, the solution to the stigmatization of sexuality in the elderly and the lack of intimacy lies above all in the work of professionals, whether they are assistants, psychogerontologists, nurses or assistants who are in direct contact with the elderly. This is why it is important to prevent (by knowing about neurodegenerative diseases), to know how to discern consent, to advise and gather information and, above all, to de-dramatize situations in which affectionate behavior occurs, to de-dramatize situations in which affectionate behaviors occur, as well as to find solutions to inappropriate behaviors.and to find solutions to inappropriate behaviors, always from a Person-Centered Care approach and from the evaluation within the clinical context.

Bibliographical references:

• Villar, F., Triadó, C., Celdrán, M., Fabà, J. (2017) Sexuality and Institutionalized Elderly People: the resident's perspective and the professional's perspective. Madrid: Fundación Pilares.