Namaste

With over a decade of going into geriatric homes to provide therapy I have seen that it holds true that while jokes are a frequent occurrence in our day-to-day activities, little time or attention is devoted to sexuality, and more so as it pertains to elders. The reality is that sexuality is a core characteristic of who we are, it is a state of mind, yet it is a holistic concept that is shied away from. If we are not understanding of, and comfortable with our own sexuality, we will forever be uncomfortable with that others, especially when our interactions with them require frequency and/or proximity. At different times and locations I have been told by Matrons to be careful with one or two of the male residents as it requires little physical stimulation for them to become erected or flirtatious. Was this alert given because there was possible threat of me being raped by a double amputee with an erection, or an arthritic 93-year-old who has fifteen children and feels I am the best candidate for the sixteenth? Really?

To me this speaks to how deeply embedded it is that sex and sexuality are provinces of the young. Thus aging men are dirty if they show any interest in sex, while aging women are resigned to spirituality and participate more in religious engagements fostered by the homes. Hello, don’t we know by now that we can be sexual without engaging in sex? We have heard that pleasuring, cuddling, and touching have been found to be more important among the elderly as these lend to more of a qualitative experience rather than the burden projected by advertisements that emphasize performance with youthful erection that always lead to intercourse. Despite our knowledge, the concept that sexuality includes the ability to be intimate with another person in a mutually satisfying manner is not encouraged, though it is obvious that some residents prefer each other’s company and would spend more time sitting together and talking. Reasons are always found to separate them for fear that ‘something’ happens. With the high incidence of chronic illness experienced by residents in many nursing homes the fear might be unfounded.

As the 2007 survey done by Lindau showed, it is my experience that older adults welcome the opportunity to discuss sexuality, but instead of a discussion they are on the receiving end of snide remarks or chiding. They are encouraged to read the Bible as if all they now are is a spiritual being and the fact that they know that their sexuality is still an integral part of themselves, they are expected to go with what is socially acceptable in the nursing home and suppress their feelings and expressions. I would hope that somewhere in the Caregiving curriculum it was mentioned that learning about sexuality is a lifelong process, a lifelong adventure. And once the residents are alive, shying away from this is not an option. Maybe taking stock of what constitutes sexuality can help staff to realize how very basic it is to not only the residents’ sense of self, but theirs as well.

The possibility of having a loved one reside in a home where kissing and mutual stroking is permitted may not be something that we are generally open to. Even if it was our hope that the said loved one would die quickly now that they are in foster care, what we actually project is an attitude of care and we state intentions that our loved one would receive the best of care leading to a good quality of life while there. Well, with a good quality of life comes the potential for continuing the activities we did in the various areas we did them, so we cannot get to pluck sexuality out of the pile. And really, there is no need to impose our morals on them, they have their own. I recall one female resident insisting that a particular gentleman was annoying. She had told him several times that she has a husband, but he still kept sitting near her and trying to engage her in conversation. To her the proximity was a reminder of moments shared with her spouse and despite no longer residing with him it was tantamount to cheating, especially since she is a good Christian woman.

This brings to bare the understanding that the familial, cultural, and religious environments in which we develop do have an impact on our sexuality, and even when we see how we can benefit from pleasant verbal interactions, taking the high road seems to dictate that we should deprive ourselves. But maybe it is not really the high road. Maybe it has more to do with how our initial exposure to overtly sexual feelings was handled by others. For example, embarrassment, ridicule, or censure as reactions to sexual expression can leave lasting scars. On the other hand, acceptance, encouragement, and enjoyment of such feelings obviously lead to a different conclusion.

Whether we introspect or look around us we see that women have traditionally nurtured a capacity for connection and engagement with others in all forms of intimacy, while men have many friends, but the deep and honest disclosure that is vital to intimacy is not something they necessarily bring to these friendships. The psychologists would suggest that the female has a male side and the male has a female side.  Maybe being residents of geriatric homes actually provide opportunities for the adventure of switching roles. The rehashing due to Alzheimer’s, or out of sheer pride over one’s history of sexual prowess could foster intimacy without sex and be deeply satisfying. Intimacy requires self-acceptance and risk-taking, and that can be stressful depending on the personalities involved. But, hey! How bad can it get? We are talking about people who are considered to be at the end of their lives. It would be worth all the risk if when we do our weekly/monthly/annual visitation we find that they have regained their self-esteem, thanks to intimacy.