March 13, 2012
Silver sexuality: Aging expert's new book explores the need for intimacy by older adults
When a Kansas State University professor asked members of her intergenerational class what they would have done differently had they thought they might live to be 150 years old, an 85-year-old in the front row answered, "I'd have had more lovers."
College students in the class gasped.
But Gayle Doll, assistant professor in the College of Human Ecology and director of the Center on Aging, wasn’t surprised. She was becoming used to frank talk from the older generation.
The author of the new book "Sexuality and Long-Term Care: Understanding and Supporting the Needs of Older Adults," Doll has realized that older people aren't much different from younger people when it comes to sexuality and the need for intimate relationships. But she noticed that when the story involved someone living in a nursing home, it was always seen as a problem.
From administrators to state regulators, from care staff to families, Doll wants a change of attitude. Most tend to look at sexuality in long-term care as a problem, but Doll sees it as respecting individuals and realizing they need to be able to experience intimate relationships across the life span.
Baby boomers, one of the next waves who will enter nursing homes, were participants in the sexual revolution, Doll said, adding that administrators, staff and families need to be ready for them.
Many nursing homes and long-term care organizations have not had formal discussions about resident sexuality and have not developed policies or staff training to address it, Doll said. She hopes her book, published by Health Professions Press, will pave the way. Doll's book includes her research to gauge the frequency of sexual expression in nursing homes.
"There is a shortage of research on this subject," she said.
Doll defines intimacy and sexuality as acts ranging from a compliment to sex. Sexual expression can be as simple as getting one's hair done to be attractive -- not sexually attractive but feeling attractive enough to hear the words, "You look so nice today," Doll said. Physical touch is also important.
"One woman told me she manufactures ways to get hugged," Doll said.
She told the story of a man who said living a nursing home was like being homeless because of the lack of intimacy. He once told a staff member, who placed a hand on his back to guide him, "Thank you for touching me. It's the first time I've been touched since my wife died."
Doll sees obstacles in nursing homes that prevent acceptance of sexual expression by residents.
One is administrators and staff. Often a little bit of education will help them create a policy and guidelines to help address issues such as inappropriate places for inappropriate activities and resident health and safety, Doll said.
At one Kansas long-term care facility, the Center on Aging staff conducted training on sexuality and revisited the facility six months later.
"We found staff putting 'do not disturb' signs on doors and pushing beds together," Doll said. "They were becoming aware that each resident is a whole person."
Another hurdle is the resident's family. Doll's research indicates a wide range of family reactions to sexual expression in a nursing home setting. Most reaction was supportive or indifferent. But 25 percent of respondents were unsupportive, and many were angry or embarrassed. One wrote that the family members had been humiliated by their mother's actions, Doll said.
Her advice to adult children: Just because parents don't talk about sex doesn't mean they don't think about it. Acknowledging the need for sexual expression "honors the person that the older person is now," Doll said.
For students, it's a revelation to realize that older adults think about sex, Doll said. She called awareness a giant step forward to overcome obstacles.
One example, she said, was the public story about retired Supreme Court Justice Sandra Day O'Connor accepting her husband's growing affection for another Alzheimer patient in an assisted-living center. The O'Connors had been married for 54 years; John O'Connor was diagnosed with Alzheimer's in 1990.
Doll also pointed to the 2007 film "Away from Her" about a couple struggling with Alzheimer's disease.
"The memory of love is present even if one's memory is compromised," Doll said.
"Sexuality and Long-Term Care: Understanding and Supporting the Needs of Older Adults" targets those who work with long-term care facilities, but it can serve as a handbook to others on such topics as staff attitudes, family influences, dementia, inappropriate behaviors, health and policy. She also provides case studies and related activities.