April 7, 2006

Aging Connection

Intimacy in the later years

By Vivian I. Silva, Gerontologist
Special to the Times

“Just because I’m in my 80s, doesn’t mean I want you to give me a flannel nightgown!” insisted one of my elderly patients.

My client’s comment was the first time since working with elders that I became aware of aging and sexuality. A frail, homebound client living alone, she was answering the question regarding a gift for the holiday gift baskets.

The program allowed my clients to choose one main gift they wanted or needed. She wanted a silky nightgown because she wanted to feel attractive. I don’t even remember a class in graduate school where we discussed sexuality and aging.

Facilitating support groups for separated and/or divorced persons 50 and older, I soon discovered that the participants wanted to talk about sexuality and intimacy.

One woman told me, “I couldn’t talk to my husband about sex, I’m not sure I can talk about it in this group.” A male participant shared, “I envy the way my son can go on a ski trip with his male and female friends—it’s not about sex, they’re good friends. I never learned how to have female friends.”

Needless to say, the comments helped me realize the importance of these topics not only for my clients but also for increasing awareness for professionals like myself. Thus, I became open to discussions about intimacy in later life as well as educating my students in the gerontology program at San Jose State University.

The following information represents areas of discussion with clients and/or topics in my workshops:

- No matter one’s age, most people want a close physical and emotional relationship with someone. A myth is that older adults just don’t care anymore. Some don’t, but many still want to touch and be touched, to love and be loved.

- Intimacy doesn’t necessarily mean engaging in sex. Older adults tend to be touch deprived. Putting lotion on your family member’s hands can be an intimate experience.

- Widows often tell me they miss forms of affection such as cuddling. They miss the relationship of having someone care and they miss being needed. Studies show that because women outlive men, there is a shortage of available partners for women.

- Society has a negative attitude toward these basic needs of older adults, but due to advocacy for a patient’s rights, nursing homes now allow privacy—couples were often separated without regard for intimacy or sex.

- Normal aging brings physical changes for both men and women. For example, men may find it takes longer for an erection. Vaginal dryness may offer challenges for women.

- Mental health issues or a disease such as diabetes as well as medications can interfere with one’s libido. Elders have told me they would like physicians to be more willing to discuss side effects of the diseases and/or medications as they relate to sex and intimacy.

- One in 10 persons with AIDS is 50 years of age or older. Women think that condoms aren’t necessary because they are past childbearing age, but sex without protection puts them at risk. Women often need coaching to insist their new partner get tested.

- Sexuality also involves one’s sexual identity. Studies suggest up to 10 percent of men and women over 65 are gay or lesbian. While grieving the loss of his partner, the residents in a housing development ignored one of my clients when they found out the “brother” that died was not really his “brother.”

Our society has a long way to go to acknowledge that older adults still have sex and strive for intimacy. When was the last time you watched a movie showing elders engaging in a healthy sexual relationship? Foreign films show sex and intimacy in later life as a normal part of aging. No jokes, no gags. Sexuality continues throughout the human life cycle.

I’m still looking for the television ad regarding safe sex with a white-haired adult rather than a teenager or college age student. Viagra ads stand out but we know taking the pills doesn’t necessarily improve intimacy.

After a speech, a male about 70 years of age came up to me and said “Viagra is great. I can have sex several times a day now. Do you think that’s too much for my wife?” I asked, “Did you ask your wife?” He hadn’t.

Talking to our loved ones, with open and honest communication, enhances a couple’s intimacy and sexuality. We just have to be willing to risk starting the dialogue and stop thinking of sex as a hush, hush subject.

To submit a question for the “Aging Connection” column e-mail Gerontologist/MSW Vivian I. Silva at vivsilva@aol.com. To make an appointment with the Geriatric Advisory Program at the Almaden Valley Counseling Service call (408) 975-2988.

Calling all Caregivers!
For information regarding the new Caregiver Discussion Group starting Monday evening, April 10, please call Vivian I. Silva, Gerontologist at 408-975-2988. The group will meet for four sessions each Monday from 7:30–9 p.m. at the Almaden Valley Counseling Service, 6529 Crown Blvd., Suite D., San Jose, CA 95120. Cost is $75 for the series. The cost includes resources, support and interaction with others caring for an older adult (the group is not for professional caregivers.)