Elder justice leaders and others researching, discussing and writing about healthy sexuality and aging emphasize the need for health care providers to discuss sexuality with older clients. This blog summarizes a recent, compelling article on this topic.

• The Harry and Jeanette Weinberg Center for Elder Abuse Prevention at The Hebrew Home at Riverdale, the Brookdale Center for Longevity and Healthy Aging, and the NYC Elder Abuse Center co-sponsored the colloquium, Exploring the Sexual Rights of Older Adults: Toward Healthy Sexuality and Freedom from Victimization in Later Life. This NYC-based event brought together leaders from the fields of elder abuse, domestic violence, criminal justice, medicine and social science to examine and discuss the many dimensions of healthy sexuality and its intersection with the detection and prevention of elder abuse.
• Following this exploration, the colloquium’s co-sponsors and others co-wrote the article, The Sexual Revolution’s Last Frontier: How Silence About Sex Undermines Health, Well-Being, and Safety in Old Age. The authors point to ageism as a major barrier blocking professionals from acknowledging the range of sexual experiences older adults experience and advocate for new programs, funding and policies.

The authors highlight the following important points:

Most elder abuse - including sexual abuse - is hidden. The New York State Elder Abuse Prevalence Study found that 7.6% of respondents age 60 and older were abused, neglected, or exploited - and that for every one case that came to light, another 23.5 cases were not reported (Lifespan of Greater Rochester et al. 2011. Under the Radar: New York State Elder Abuse Prevalence Study. Self-reported Prevalence and Documented Case Surveys, Final Report. New York: William B. Hoyt Memorial New York State Children and Family Trust Fund, and the New York State Office of Children and Family Services). These statistics include all types of elder abuse, including sexual abuse. Therefore, discussing sex and sexuality with older adult clients may uncover these cases. Once the conversation is started, providers can encourage older adults to receive services and support.

Failure to discuss sex with older adults perpetuates the ageist myth that older adults are asexual. This failure results in older adults not receiving support for a healthy lifestyle and/or hinders the prevention and detection of elder sexual abuse cases. By asking questions and raising the topic of sex, we can create safe spaces where older adults can report abuse or ask for help with sexually related issues they may be facing. Dr. Mark Lachs, a geriatrician and the NYCEAC’s Medical Director, asks his patients about their sexual health and has found people receptive to discussing the topic. His patients have responded to his questions with statements such as “Wow, this person thinks I’m a human being who is actually sexually active” (Lachs, M. 2011. Exploring the Sexual Rights of Older Adults: Toward Healthy Sexuality and Freedom from Victimization in Later Life. Presentation at the colloquium, Exploring the Sexual Rights of Older Adults: Toward Healthy Sexuality and Freedom from Victimization in Later Life, May 6, 2011). (Transcript available upon request.)

Discussing sexuality with older adults provides professionals with the opportunity to gather health-related data and offer important resources. A large study on sex and aging showed that people who rated their health as “very good to excellent” were more likely to be sexually active in comparison with those who reported their heath as “poor or fair.” This presents us with an opportunity to support and empower older adults in furthering healthy sexuality in later life.

The authors present the following steps that can help us begin to fight against ageism and raise awareness of sex and aging:

• Healthcare providers should talk to their older patients about sex, and physical intimacy should be on the list of issues to be addressed in care planning.

• Healthcare providers should have procedures for handling the sexual hyperactivity that attends some dementias in order to protect both potential victims and the person exhibiting such behavior.

• Potential responders should know how to handle allegations of sexual assault in ways that protect and respect victims, preserve evidence and assure proper reporting and response.

• Law enforcement officials and prosecutors should receive training on how to identify, respond to, and pursue allegations and cases of elder sexual assault; they need better tools for learning how to proceed in the face of suspected cognitive deficits of either potential victims or alleged perpetrators.

• Professionals working in the field of aging and those working in domestic violence and sexual assault fields should share knowledge and resources to better respond to the needs of older victims of sexual assault.

• Medical and legal ethicists, along with gerontology experts, policy makers, and practitioners, should begin to discuss and provide guidance and support for those who encounter the complex issues that arise at the intersection of sex, aging, and diminished capacity.

• Researchers should devote greater attention to these complex issues (including improving our ability to assess capacity for sexual contact), and funders (federal and philanthropic) should provide resources to support such research.

Click here to read the entire article.

by Cara Kenien, LMSW, MPA, Social Media Manager, NYCEAC