Sex and the elderly: The fall of a taboo

Many in the “golden years” still want to have a fulfilled sex life. How can this be dealt with in geriatric medicine and nursing homes? How can desire be reconciled with illness and other geriatric-related questions?

Geriatric medicine needs a greater focus on the sexual needs of older people

With the baby boomers getting older, the topic is increasingly addressed: Many in the “golden years” still want to have a fulfilled sex life. How can this be dealt with in geriatric medicine and nursing homes? How can desire be reconciled with illness and other geriatric-related questions? Dr. Annette Ciurea, senior physician at the University Clinic for Acute Geriatrics at the Stadtspital Waid in Zurich, deals with this topic.

"Everyone has their own personal approach to sexuality, including physicians. We ask our patients about all kinds of health problems, but we usually know very little about their sex lives," says Dr. Annette Ciurea and continues: "The WHO report 'Age and Health' comprises a total of 260 pages - just one page is devoted to the topic of sexuality. For people with dementia, there are numerous questionnaires to track many types of behaviors, but none for sexuality."

Need for intimacy is still strong among the very elderly

To Dr. Ciurea, sexuality is an important component of "successful aging", and it has nonetheless been neglected so far. "In the Berlin BASE age study, for example, results indicated that sexual activity decreases with age, but the desire for intimacy remains," she added. This is not only about the sexual act itself, but above all about the need for tenderness and touch. The physical contact of many patients in nursing homes and geriatric departments is usually limited to the provision of body care and food.

Diseases, medication and more: numerous barriers hinder sexuality in old age

There are many barriers that have to do with aging. The body changes, menopause occurs, chronic illnesses such as diabetes appear or augment their impact. Drugs for certain diseases can also have a negative effect on libido. "Added to this, the progressive dementia of a partner can become a heavy load to cope with in the relationship,'' explained Dr. Ciurea.

Intimate gatherings: in Switzerland, sexual companionship is a solution

While sexuality can be lived more freely in the comfort of your home, there are considerable restrictions in elderly care institutions. Are residents allowed to have relationships with each other? Should rooms be set up for intimate moments? What is the effect of such topics and implementation in relatives? How do we deal with sexual behavior within the framework of disorders like dementia? These are questions with which geriatricians are increasingly confronted, especially as a new wave of golden-age “baby boomers” arrives. The cultural conditions also play a role in confronting these issues. In some places in Switzerland, for example, sexual companions are taking part in elderly care provision.

Successful aging: possible strategies for dealing with sexuality in geriatrics

"Geriatric specialists should address the issue openly and ask about their patients’ needs," says Dr. Ciurea. It is also important to understand sexuality as a component of successful aging. "We geriatricians should also be aware that our own sexuality influences how we deal with this issue in relation to our patients. Every colleague can contribute to this topic with his or her experience and questions", she added.

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