Healthy Sex Life Is Called Right Prescription for Elderly

Old age is widely viewed as a sedentary time of life, not very physical and certainly not sexual. Challenging this outlook, however, are geriatric experts opposed to forced retirement of sexuality.

Nursing homes especially can be sexually inhibiting, with residents ridiculed or prevented from enjoying physical contacts or sexual activity, one proponent of geriatric sexuality said.

“It’s an ‘ageism’ thing. Our society has such an emphasis on being young and slim,” said assistant nursing Prof. Paula Wringer of Purdue University.

“When you get older, a pot belly and your hair is a little thin, people associate that with asexuality,” she said.

She argued that the need for intimate physical contact continues throughout life and said intercourse is enjoyed by many in their twilight years.

“Masters and Johnson say if you have sex twice a week while you are 40, when you are 90, you will do the same,” barring significant illness or the death of a mate, she said.

But among those over age 65 living in nursing homes, only 10% remain sexually active, experts report.

Wringer said the elderly, as consenting adults, have a right to sexuality and privacy, although the latter is often lacking in nursing homes, where sex or even extensive physical contact among residents is generally discouraged.

Repressing sexuality, which includes simple touching and cuddling, can be just as harmful in old age as during life’s earlier stages, experts insist.

Can’t Ignore Needs

“I often say you ought to be dealing with sexuality as much as you are dealing with arthritis,” said Dr. Jane Thibault, director of the geriatric evaluation and treatment unit at the University of Louisville’s School of Medicine.

She recalled the case of a 96-year-old woman in a private care home who was physically active and even played the piano for church groups. But the staff complained that she was often seen masturbating.

“She was in a private room, and she essentially told me: ‘This is my room, I pay for it, and if they knock before they come in, I will stop. They get what they deserve,’ ” Thibault said.

Thibault, who is also a clinical gerontologist, said in too many cases, elderly people respond to criticism by becoming depressed and withdrawn.

Wringer, who consults on behavior problems of nursing home residents, agreed, saying she too has found that the problems often turn out to stem from the attitudes of nursing home staff.

“When (residents) hold hands or say they want to marry someone, there is a lot of ridicule. It can be very humiliating.”

She described the case of a 90-year-old man in a nursing home who began exposing himself and making inappropriate remarks, although earlier his behavior was normal. She found that the staff had been laughing at the man for holding hands with a woman friend in the home.

“He was being treated like a child, so in his own unconscious way, he was saying: ‘Look at me. I’m still a man. I’m still a human being,’ ” said Wringer.

As a solution, Wringer conferred with the staff and also arranged for the couple to have a few hours of privacy together each week.

Most nursing homes don’t say specifically that they have a policy barring physical contact between residents, but Wringer said residents get the message through “a campaign of indifference.”

“They are made to feel naughty instead of, ‘It’s OK, you’re an adult,’ ” and they may get no human physical contact except when receiving medical services, she said.

Regulations governing Medicaid and Medicare benefits also can restrict companionship among the elderly when couples are forced to live apart because both cannot get reimbursed for living in a facility providing care that only one needs.