From this guest lecture, I was able to take away several key points that could assist me in working with my older adult clients one day. We discussed sexuality as a whole, but also focused on changes that occur as we age that can affect sexual activity as an ADL. Many statistics shared were surprising and suggest that sex has an impact on the overall health and well-being of our clients.
The first thing that stood out to me was the amount of bodily changes a woman goes through during menopause and how that can affect her quality of life. A woman at the age of 40 has about half the level of testosterone as she did at age 25. We can step in here and educate our clients.
Something else that was interesting to me was looking at a person's upbringing and how that might impact their sexual health. Whether or not sexuality was discussed in the home and any sex education they may have received has a large impact on how they are going to talk about and approach sexual relationships. Religion is also a huge factor, especially being in the "Bible belt". This could affect how our clients speak to us about their needs, especially if they are struggling and do not want to feel shameful approaching someone for help. We have talked about ACE's in other courses and this could also greatly affect their sexual health as they age, or even in younger clients.
These facts related to co-morbidities were not as surprising to me, but they definitely need to be addressed:
The first thing that stood out to me was the amount of bodily changes a woman goes through during menopause and how that can affect her quality of life. A woman at the age of 40 has about half the level of testosterone as she did at age 25. We can step in here and educate our clients.
Something else that was interesting to me was looking at a person's upbringing and how that might impact their sexual health. Whether or not sexuality was discussed in the home and any sex education they may have received has a large impact on how they are going to talk about and approach sexual relationships. Religion is also a huge factor, especially being in the "Bible belt". This could affect how our clients speak to us about their needs, especially if they are struggling and do not want to feel shameful approaching someone for help. We have talked about ACE's in other courses and this could also greatly affect their sexual health as they age, or even in younger clients.
These facts related to co-morbidities were not as surprising to me, but they definitely need to be addressed:
- Hardening of arteries and Diabetes both cause changes in the nerve fibers and blood vessels in the penis making it more difficult to obtain and maintain erections.
- Arthritis can make certain sexual acts challenging or painful.
- Cancer and its treatment can cause fatigue, depression and produce a changed sexual response.
- High blood pressure damages the lining of blood vessels, causes arteries to harden and narrow, and therefore, limits blood flow. It can interfere with ejaculation and reduce desire.
- Obesity and sexual health: The higher the body fat percentage, the less freefloating testosterone. Obese people will notice a significant increase in sex drive if they lose just 10% of their total weight
Not only these health conditions, but any medications related to these can greatly impact sexual drive, testosterone levels, self-lubrication, and feeling comfortable in one's body.
Where do we as OT's come in?
One intervention that comes to mind is education on energy conservation. For example, say we have a client who is going through cancer treatments but still wants to have a sexual relationship with their spouse. We can educate on ways to reduce fatigue and better scheduling intimacy so that it can still be enjoyable.
We can provide nutrition and exercise interventions with an obese client who is expressing concern about their sex drive.
For a client who is widowed or socially isolated, we can provide resources and leisure interests for them to meet new people.
We can lead groups on sexual health in the aging adult at community centers, skilled nursing facilities, and even group homes for those with intellectual disabilities.
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