Dupree Aging and Sexual Health

I learned a lot from the lecture on Aging and Sexual Health. I really liked the approach that Dr. Valli took on aging and sexual health; she helped take some of the confusion and awkwardness out of the subject. Sexuality is a sensitive topic even when age is not a factor, but talking about sexuality with the geriatric population can prove even more uncomfortable for both parties. Why is this? In my opinion it is a lack of information, and comfort around the subject. It was helpful hearing from a sex therapist that there is no normal when it comes to sexuality, so expressing this to our clients may help relax them when bringing up this subject with them. Also I feel like the generation in the elderly role has attributed shame and guilt around sex especially being in the “Bible belt.” It was interesting to learn about the differences between males and females and how they respond sexually, it is also interesting to me how psychological sex is and understanding that can help client interaction. I still find some ambiguity with our role as therapists when it comes to sexual health and what is in our scope. I of course know that sexual activity is an ADL, so yes it is in our scope of practice. When interacting and talking about sexual activity it is important to use the PLISSIT model. First is permission, followed by limited information, specific suggestions, and intensive therapy. This is important to keep in mind with any sensitive topics, and sexual activity is especially sensitive. With the older population many will be in long-term relationships which cause changes in sex drive, and with increased age also comes physical changes which are important to relay to our clients.

It is important to first use the PLISSIT model and assess the client’s comfort with the subject. An example of  an intervention that could be used would be educating a client on positioning, while engaging in sexual activity. For example a male client who has a posterior THA, and has expressed that he would like to be intimate with his wife, but he is afraid of breaking his hip praucations. It is in our scope of practice to educate and help him problem solve through this situation. Having the client actively engage and input preferences that he and his spouse have in the bedroom will be key, and you can show him positions or give handouts that would be helpful.
A second intervention could be used with a RA support group for women. I would first find out in a prior intervention session if sexual activity is limited by the group member’s RA, and if yes I would have a treatment session where we could problem solve as a group on different things that they can do to help with this limitation. It would be very helpful for them to learn from their fellows who are going through the same difficulties that they are and how they manage.