Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T15:37:27.952Z Has data issue: false hasContentIssue false
  • English
  • Français

Sexuality, aging, and dementia

Published online by Cambridge University Press:  14 March 2012

Susan Mary Benbow  and
Derek Beeston
Susan Mary Benbow*
Affiliation:
Centre for Ageing and Mental Health, Staffordshire University, Stafford, UK
Derek Beeston
Affiliation:
Centre for Ageing and Mental Health, Staffordshire University, Stafford, UK
*
Correspondence should be addressed to: Susan Mary Benbow, Visiting Professor, Centre for Ageing and Mental Health, Faculty of Health and Sciences, Staffordshire University, Blackheath Lane, Stafford ST18 0AD, UK. Phone: +44 7789 485435, +44 1785 353742. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Sexuality in later life and its relationship to dementia is a neglected topic: greater understanding of the area has the potential to contribute to the quality of life of people with dementia, their family members, and formal carers. We review current knowledge about sexuality, aging, and dementia.

Methods: We undertook a review of the recent literature to examine of the following areas: what is known about sexuality and aging, and about attitudes to sexuality and aging; what is known about the relevance of sexuality and aging to people living with dementia and their care; and the management of sexual behaviors causing concern to others.

Results: Sexual activity decreases in frequency with increasing age but many older people remain sexually active; there is no age limit to sexual responsiveness; and sexuality is becoming more important to successive cohorts of older people, including people living with dementia and gay, lesbian, bisexual, and transgendered elderly people. Attitudes and beliefs toward sexuality and aging are strongly influenced by stereotypes and myths, not only among the general public but also among those working in health and social care.

Conclusions: Professional bodies should include sexuality, aging, and dementia in their training curricula. More work is needed on the impact of environmental issues, particularly in group living situations, on older adults’ sexuality, and on consent issues. Ethical decision-making frameworks can be useful in practice. Organizations should investigate how to support staff in avoiding a problem-orientated approach and focus on providing holistic person-centered care.

Keywords

attitudesdecision-making frameworksdementia workforceeducationintimacyrelationshipsresidential/nursing caresextraining
Type
Review Article
Information
International Psychogeriatrics , Volume 24 , Issue 7 , July 2012 , pp. 1026 - 1033
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Age Concern (2002). Opening Doors to the Needs of Older Lesbians, Gay Men and Bisexuals: Report of the One-Day Conference Held in London in April 2002. London: Age Concern.Google Scholar
Age Concern (2006). The Whole of Me . . . Meeting the Needs of Older Lesbians, Gay Men and Bisexuals Living in Care Homes and Extra Care Housing: A Resource Pack for Professionals. London: Age Concern.Google Scholar
Alagiakrishnan, K. et al. (2005). Sexually inappropriate behaviour in demented elderly people. Postgraduate Medical Journal, 81, 463–466.CrossRefGoogle ScholarPubMed
Allen, R. S., Petro, K. N. and Phillips, L. L. (2009). Factors influencing young adults’ attitudes and knowledge of late-life sexuality among older women. Aging and Mental Health, 13, 238–245.CrossRefGoogle ScholarPubMed
Archibald, C. (1998). Sexuality, dementia and residential care: managers report and response. Health and Social Care in the Community, 6, 95–101.CrossRefGoogle ScholarPubMed
Beckman, N., Waern, M., Gustafson, D. and Skoog, I. (2008). Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971–2001. BMJ, 337, a279.CrossRefGoogle ScholarPubMed
Beehler, G. P. (2001). Confronting the culture of medicine: gay men's experiences with primary care physicians. Journal of the Gay and Lesbian Medical Association, 5, 135–141.CrossRefGoogle Scholar
Benbow, S. M. and Jagus, C. (2002). Sexuality in elderly women with mental health problems. Sexual and Relationship Therapy, 17, 261–270.CrossRefGoogle Scholar
Berger, R. M. (1982). The unseen minority: older gays and lesbians. Social Work, 27, 236–242.CrossRefGoogle Scholar
Bouman, W. P., Arcelus, J. and Benbow, S. M. (2007). Nottingham Study of Sexuality and Ageing (NoSSA II): attitudes of care staff regarding sexuality and residents – a study in residential and nursing homes. Sexual and Relationship Therapy, 22, 45–61.CrossRefGoogle Scholar
de Medeiros, K., Rosenberg, P. B., Baker, A. S. and Onyike, C. U. (2008). Improper sexual behaviors in elders with dementia living in residential care. Dementia and Geriatric Cognitive Disorders, 26, 370–377.CrossRefGoogle ScholarPubMed
Department of Health (2001). The National Strategy for Sexual Health and HIV. London: Department of Health.Google Scholar
Department of Health/Care Services Improvement Partnership (2005). Everybody's Business: Integrated Mental Health Services for Older Adults – A Service Development Guide. London: Department of Health.Google Scholar
Department of Health (2007). Older Lesbian, Gay and Bisexual (LGB) People. Briefing no.4. London: Department of Health.Google Scholar
Ehrenfeld, M., Tabak, N., Bronner, G. and Bergman, R. (1997). Ethical dilemmas concerning sexuality of elderly patients suffering from dementia. International Journal of Nursing Practice, 3, 255–259.CrossRefGoogle ScholarPubMed
Ehrenfeld, M., Bronner, G., Tabak, N., Alpert, R. and Bergman, R. (1999). Sexuality among institutionalized elderly patients with dementia. Nursing Ethics, 6, 144–149.CrossRefGoogle ScholarPubMed
Elias, J. and Ryan, A. (2011). A review and commentary on the factors that influence expressions of sexuality by older people in care homes. Journal of Clinical Nursing, 20, 1668–1676.CrossRefGoogle ScholarPubMed
Eloniemi-Sulkava, U. et al. (2002). Spouse caregivers’ perceptions of influence of dementia on marriage. International Psychogeriatrics, 14, 47–58.CrossRefGoogle ScholarPubMed
Fish, J. (2006). Heterosexism in Health and Social Care. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
Ginsberg, T. B., Pomerantz, S. C. and Kramer-Feeley, V. (2005). Sexuality in older adults: behaviours and preferences. Age and Ageing, 34, 475–480.CrossRefGoogle ScholarPubMed
Gott, M., Hinchliff, S. and Galena, E. (2004). General practitioner attitudes to discussing sexual health issues with older people. Social Science and Medicine, 58, 2093–2103.CrossRefGoogle ScholarPubMed
Gray, H. and Dressel, P. (1985). Alternative interpretations of aging among gay males. Gerontologist, 25, 83–87.CrossRefGoogle ScholarPubMed
Heaphy, B., Yip, A. and Thompson, D. (2003). Lesbian, Gay and Bisexual Lives Over 50: A Report on the Project “The Social and Policy Implications of Non-Heterosexual Ageing” (Funded by the Economic and Social Research Council, Award Number: R000223465). Nottingham: York House.Google Scholar
ILC-UK (2011). The Last Taboo: A Guide to Dementia, Sexuality, Intimacy and Sexual Behaviour in Care Homes. London: ILC-UK.Google Scholar
Jagus, C. and Benbow, S. M. (2002). Sexuality in elderly men with mental health problems. Sexual and Relationship Therapy, 17, 271–279.CrossRefGoogle Scholar
Johnson, A. M. et al. (2001). Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet, 358, 1835–1842.CrossRefGoogle ScholarPubMed
Kehoe, M. (1986). Lesbians over 65. Journal of Homosexuality, 12, 139–152.CrossRefGoogle ScholarPubMed
Kehoe, M. (1988). Lesbians over 60 speak for themselves. Journal of Homosexuality, 16, 1–111.Google ScholarPubMed
Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O'Muircheartaigh, C. A. and Waite, L. J. (2007). A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357, 762–774.CrossRefGoogle ScholarPubMed
Loue, S. (2005). Intimacy and institutionalized cognitive impaired elderly. Care Management Journals, 6, 185–190.CrossRefGoogle ScholarPubMed
Mahieu, L. and Gastmans, C. (2011). Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature. International Psychogeriatrics, 24, 346–357.CrossRefGoogle Scholar
Nagaratnam, N. and Gayagay, G. (2002). Hypersexuality in nursing care facilities: a descriptive study. Archives of Gerontology and Geriatrics, 35, 195–203.CrossRefGoogle ScholarPubMed
NHS Inclusion Project (2006). Fair For All – The Wider Challenge: Good LGBT Practice in the NHS. Glasgow: NHS Inclusion Project.Google Scholar
Pope, M. and Schulz, R. (1990). Sexual attitudes and behavior in midlife and aging homosexual males. Journal of Homosexuality, 20, 169–177.CrossRefGoogle ScholarPubMed
Power, L., Bell, M. and Freemantle, I. (2010). A National Study of People Over 50 Living With HIV. York: Joseph Rowntree Foundation.Google Scholar
Prakash, R., Pathak, A., Munda, S. and Bagati, D. (2009). Quetiapine effective in treatment of inappropriate sexual behavior of Lewy body disease with predominant frontal lobe signs. American Journal of Alzheimer's Disease and Other Dementias, 24, 136–140.CrossRefGoogle ScholarPubMed
Rheaume, C. and Mitty, E. (2008). Sexuality and intimacy in older adults. Geriatric Nursing, 29, 342–349.CrossRefGoogle ScholarPubMed
Roach, S. M. (2004). Sexual behaviour of nursing home residents: staff perceptions and responses. Journal of Advanced Nursing, 48, 371–379.CrossRefGoogle ScholarPubMed
Robinson, J. G. and Molzahn, A. E. (2007). Sexuality and quality of life. Journal of Gerontological Nursing, 33, 19–27.CrossRefGoogle ScholarPubMed
SAGA Health (2011). Sex and Romance Alive for the Over 50's. Available at: http://www.saga.co.uk/media-centre/press-releases/2011/sex-and-romance-alive-for-the-over-50s.asp.Google Scholar
Scottish Executive Health Department (2005). Respect and Responsibility Strategy and Action Plan for Improving Sexual Health. Edinburgh: Scottish Executive.Google Scholar
Stevenson, K., Davies, A. and Gunn, M. (2004). Blackstone's Guide to the Sexual Offences Act 2003. Oxford: Oxford University Press.Google Scholar
Taylor, A. and Gosney, M. A. (2011). Sexuality in older age: essential considerations for healthcare professionals. Age and Ageing, 40, 538–543.CrossRefGoogle ScholarPubMed
Tucker, I. (2010). Management of inappropriate sexual behaviors in dementia: a literature review. International Psychogeriatrics, 22, 683–692.CrossRefGoogle ScholarPubMed
Waite, L. J., Laumann, E. O., Das, A. and Schumm, L. P. (2009). Sexuality: measures of partnerships, practices, attitudes, and problems in the National Social Life, Health, and Aging Study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64B, i56–i66.CrossRefGoogle Scholar
Wallace, M. and Safer, M. (2009). Hypersexuality among cognitively impaired older adults. Geriatric Nursing, 30, 230–237.CrossRefGoogle ScholarPubMed
Ward, R., Vass, A. A., Aggarwal, N., Garfield, C. and Cybyk, B. (2005). A kiss is still a kiss? The construction of sexuality in dementia care. Dementia, 4, 49–72.CrossRefGoogle Scholar
Welsh Assembly Government (2010). Sexual Health and Wellbeing Action Plan For Wales, 2010–2015. Cardiff: Welsh Assembly Government.Google Scholar
World Health Organization (2006). Defining Sexual Health: Report of a Technical Consultation on Sexual Health. Geneva: WHO.Google Scholar