Chapter 13: Sexuality & Aging: Nursing Considerations

Sexuality & Aging: Nursing Considerations identifies a significant gap in healthcare where providers often overlook these needs due to ageist myths or personal discomfort, which can lead to older patients being discharged with unaddressed sexual dysfunctions. The text details normal physiological shifts in the urogenital systems, such as the androgen decline in the aging male (ADAM), which includes decreased testosterone and longer refractory periods, and menopausal changes in women like atrophic vaginitis, decreased lubrication, and dyspareunia. Pathological conditions including the rising rates of HIV and AIDS in those over 55, various malignancies such as prostate and breast cancer, and dementia-related behaviors like hypersexuality or disinhibition are explored to provide a comprehensive view of the clinical challenges faced in later life. Furthermore, the discussion covers environmental barriers in long-term care facilities, such as a lack of privacy, and the unique social isolation and discrimination often encountered by the aging LGBT community. Nurses are encouraged to utilize the nursing process and assessment frameworks like the PLISSIT model to conduct sensitive histories and physical evaluations. Interventions discussed include providing education on normal age-related changes, suggesting alternative coital positions, managing medications that impact libido, and promoting the therapeutic value of touch and massage as valid forms of intimacy when traditional intercourse is not desired or possible. Ultimately, the sources advocate for a supportive healthcare environment that validates the sexual rights and well-being of older adults to enhance their overall quality of life.