Seniors and Sexual Health

Among the misunderstandings, assumptions and myths about aging and there are many — the ones surrounding seniors and sex are probably the least addressed. Whether we don’t believe it or don’t want to believe it, the answer to the question, “Are they …?” is “Yes.”

Yes, they can. And, yes, they are.

If you’re squirming while reading this, relax. No one has ever died of embarrassment from reading a blog, and we’re not going to change that today.

“Sexuality, sexual health and sexual awareness are part of overall physical, emotional and psychosocial wellness,” said Nina Louis, vice president of health services for Phoenix, Arizona, senior living community Beatitudes Campus. “When it comes to topics around sex and sexual health, we did a fairly good job of normalizing conversations with our teens and young adults. But for some reason we seem to revert backwards with seniors,” she added. “No one wants to talk about sex among older adults!”

If you’re wondering why it matters, consider this: The youngest of the Boomers turn 60 in 2024. We have an entire generation of Americans who grew up during the sexual revolution of the 1960s and 1970s. Many sex experts (yeah, there are researchers and physicians whose expertise is sexuality) believe these Boomers will not only be more comfortable with conversations and policies related to their sex lives and their sexual health — they are going to demand them.

So what does that mean for you? Whether you are a senior yourself, an adult child helping your elderly parent navigate life or a caregiver in a senior living community — it means it’s time to get uncomfortable: Let’s talk about sex.

Why Are You Blushing?

“I think our hesitancy to talk about sexual health openly is related to society’s general views on sex,” said M. Aaron Guest, Ph.D., an assistant professor of aging at the Center for Innovation in Healthy and Resilient Aging at Arizona State University. “In American culture, we don’t talk about sex broadly, so it makes sense we’re reluctant to address older adults and sex.”

How we look at aging simply compounds the reluctance. In other words, how we see sex as a culture intersects and oddly mirrors how we view aging: we know both are essential parts of life but we’d prefer not to talk openly about either. Mix the two topics, and, from many people, you have a big helping of No Thanks.

The role media plays in perpetuating age stereotypes is widely known. A study from the World Health Organization that looked at TV programming, works of fiction, and magazine and newspaper articles found negative descriptions of older adults outnumber positive ones by six times. Negative descriptions tend to be physical and focused on mood: “Gran is so slow.” “Gramps is so cranky.” While positive ones tend to center on behavioral or personality traits: “Nana is so wise.” “Pops is so kind.”

“When we have such firm beliefs about how older people in our lives are or should be, it’s hard to view them any other way,” Dr. Guest said. But the best way to reduce ageism, he explained, is building connections with older adults — spending time and creating meaningful interactions. This, we know, can lead to not only accepting but also acknowledging that older people are vibrant, and their contributions to the world and at all levels is vital.

Seems relatively straightforward. But when the way we view seniors and the way we view sex collide, we end up with a sociological conundrum of pure discomfort that is spelled with two simple letters: ew.

But why does it matter? Who does it hurt to pretend you don’t know (or, more accurately, don’t want to know) that your 80-year-old mom is sexually active? Turns out, pretending ignorance is what further perpetuates those negative stereotypes about aging. And believe it or not, it contributes to unaddressed health issues for seniors.

Are Seniors Having Sex?

Just like any other age demographic, statistically speaking, a major factor in whether someone is sexually active is whether they have a partner or not. Single in your 30s? Unattached in your 40s? Widowed in your 70s? A yes answer to any of these means you’re less likely to be experiencing intimacy with another person.

“It’s really no different for seniors. If they’re not in a relationship, chances are they are not having sex,” Dr. Guest said. “Because many older people are widowed, separated or divorced, or otherwise not partnered, many older people may not be sexually involved.” But it doesn’t mean they don’t want to be or cannot.

Although there is not widespread research on sexual activity and sexual desire among retirees, in an AARP Healthy Aging Poll of 65- to 80-year-olds, two-thirds said they were interested in sex, and more than 50% said sex was important to their quality of life.

According to Dr. Guest, sexual activity is an integral part of health and well-being and it correlates with greater enjoyment of life for older adults. “Sex changes as we age. How we think about it, how we feel about it and how we do it,” he said. “People may modify their sexual activity because of physiological changes, but it doesn’t make it any less important to them.”

How Is Sex Different as We Age?

“There is no doubt individuals who are in better health are having more sex,” said Dr. Guest. “But we see this across all populations, not just older individuals.” Things that tend to slow us down — not feeling well, aches and pains, a chronic illness or condition — in general may slow us down in intimate situations. Sex after 60 may change a bit if we are not at our physical best.

Arthritis makes hands a bit stiffer and not as adroit in touch. Tightness in joints causes us to move in different ways than we did as younger people. Weight gain or even weight loss affects how we interact physically with one another. Medicines we take can also have side effects that impact our desire, mood and body in ways that make sex less appealing or more difficult.

The physiological changes to our bodies certainly change how we approach intimacy as we age and may change sex techniques after 60, 70 or 80. Dr. Guest pointed out that biological shifts can impact both sexual desire and sex itself. So answering the question, “Can a 70-year-old woman be sexually active?” is easy: Of course she can, but perhaps she and her partner approach it differently. For women, the vaginal wall becomes thinner, making sex sometimes uncomfortable. For men, sperm production continues into their 90s but maintaining an erection can be more challenging. Accommodating these physical changes and overcoming the challenges our bodies present to us is possible, but it requires communication with your partner and even with your healthcare professional.

Unfortunately, the societal reluctance to talk about sex and sexual health extends into the medical profession. “Doctors aren’t always asking the right questions of their senior patients,” Dr. Guest said. “Our hope is that with better education, this is changing. But there are fewer geriatricians practicing now, so sexual health for seniors is something we all have to work on together as a society and as a community.”

Larger hospital systems, senior living communities and long-term care facilities, community senior centers, YMCAs and YWCAs all have a role to play in supporting seniors in feeling their best. And sometimes that means offering information about sexual health and becoming more comfortable addressing questions and concerns.

Why Does Talking About Sex With Seniors Matter?

Although the rumor that senior communities are breeding grounds for sexually transmitted diseases (STDs) is false, it is true that as people age their immune systems tend to weaken, making them more susceptible to contracting any disease — including STDs. If doctors are not asking and seniors are too embarrassed to share concerning symptoms, the likelihood of spreading disease is higher. Allowing a health issue to go untreated also can have serious consequences for the person experiencing symptoms and possibly their partner.

“Sexual health is part of overall health,” Beatitudes Campus’ Nina Louis said. “It really is important for us, as a society, to be ok with talking with seniors about sex.”

Given the aging of our population and the availability of drugs and devices to enhance sexual function, healthcare professionals must be prepared to address sexual concerns with older patients and to answer the question, “Is sex healthy for seniors?” Discussions about sex are infrequent, partly because physicians might, themselves, unwittingly accept misconceptions about the sexual function of older adults.

Senior living communities can play a significant role in normalizing these conversations. Offering educational materials and resources on sexual health for seniors, providing access to condoms and encouraging care providers on staff to be open to questions from residents are all impactful ways to make a difference.

When Intimacy Doesn’t Always Mean Sex

The frequency of sexual intercourse may decline with age, but that doesn’t necessarily mean older adults are not sexually active or intimate in other ways.

In her career as a healthcare administrator in senior living, Louis said she has seen a greater importance on “expressions of love” between older individuals. “Sexuality changes as we age,” Louis said. “Expressions of love outside of sexual interactions sometimes become more important.” Think: holding hands, hugging, kissing and simply holding one another close. All of these forms of affection can satisfy the need for intimacy as we grow older.

A Different Kind of Fall Risk

One other aspect of finding love (or physical attraction) later in life is the time it takes to become smitten. “Courtships for seniors tend to be quicker,” Dr. Guest said. “Mature adults are aware they have limited time, so they may appear to fall for one another too fast.” Which, he points out, can be difficult for adult children who see their 80-year-old mom falling in love after six weeks. Watching movies, sharing a meal, going for walks — all without the stresses they carried when they were much younger can create the perfect opportunity for connection between seniors. Those connections are very real and so important for satisfaction with life as we age.

At Beatitudes Campus, Louis said she sees residents falling in love and seeking out romantic relationships at all ages and stages of life. “We see residents finding companionship and affection in our community, and we embrace it.” Staff do, from time to time, talk with residents and family members about residents who meet and fall in love at the community and subsequently want to move in together on campus. But interestingly, she said residents generally choose to maintain their own residences even in committed relationships.

“More often than not, everyone is happy to stay in their own apartment and continue a romantic relationship,” Louis added. “One of the great advantages of finding love later in life is that you do not have to accept a traditional arrangement. You can stay independent and spend time together on your own terms.”

Finding love later in life also means things that bothered you in relationships as a younger person — dirty socks on the floor, not helping enough around the house — don’t matter anymore. “Perspectives shift for older adults,” Dr. Guest pointed out. “They’re more willing to live with differences.”

Late-Life Love Is Still Love

Dr. Guest references a book by literary critic, Susan Gubar, “Late-Life Love” as offering a great perspective on how seniors feel about love and sex as they progress in life. The memoir, according to Amazon reviews “offers a resounding retort to ageist stereotypes, appraises the obstacles unique to senior couples and celebrates second chances.”

For residents at Beatitudes Campus, celebrating love and romantic bonds has become an important part of the community these vibrant seniors and supportive staff have created for themselves.

Commitment ceremonies are celebrated widely, as couples — both opposite and same sex — stand before one another and their neighbors and friends to declare their union sacred. “On this campus, people turn out to support love,” Louis said. “There is a ton of support for a couple — from their own neighbors and our team members. We show up for them because we have close relationships with the residents and are intentional about showing that level of care.”

To experience life at Beatitudes Campus, come see us. Call for a personal tour: (602) 833-1358.

Featured Image: Yuri A / Shutterstock