Many older people become dependent on care, which requires them to move into a nursing home or receive care at home. In some cases they then need help to re-define their sexuality. This is not naturally seen as part of care. To change this, Rutgers (Center of Expertise on sexuality) and Vilans have joined forces. ‘Even when you are old and need care, most people want to be touched,’ says Ymke Kelders, expert on sexuality and care at Rutgers.
In 2021, the Netherlands counted about 3.2 million Dutch people aged 65 and older, many of whom are still sexually active. Research shows that although sexual activity declines as people age, it does not stop for most. Among people aged 55-70 years old, 69 percent have had sex with a partner in the past six months. Among those 70-80 years olds – the figure is 51 percent. 83 percent of men and 61 percent of women aged 55-79 say sex is important.
Better sex life
Growing older has a number of advantages for sexual well-being:
- There is often more time for each other
- There’s no more work or children who live at home
- Contraception against pregnancy no longer plays a role
- People often know well what they want and a lot of intimacy has been built up in long-term relationships
Some older people say their sex life has only gotten better because of all these factors. But what happens when you move into a nursing home and everyone can suddenly walk in and out? How do you deal with the fact that after 50 years of sleeping next to each other you suddenly can’t do this anymore? Or someone can no longer be intimate in the way they would like because of medication or illness? This is where care and support are needed.
Difficult to start the conversation
In elder care, fortunately, the needs of residents/clients for intimacy and sexuality are increasingly being recognised. Making this topic negotiable is a next step, which most care professionals are still not well equipped for. Ymke: “Care professionals are always faced with people’s sexual needs or issues, an erection while bathing, people wanting to cuddle, people with dementia falling in love (again), inappropriate sexual behaviour. However, we see that healthcare professionals find it difficult to start the conversation. They don’t know what to look out for and they often wonder if they have enough knowledge in-house.’
Noëlle Sant (Vilans): ‘At least realise that the need may be there, so ask about it. I say: look at the caregivers with your rose-colored glasses on. Then you will see different things. And let’s not forget that older people can also be LGBTQA+. Pay attention to that too. Ask about a partner, and not whether someone was married.’
Signalling role
A poll shows that these are the main reasons for not talking about this:
- Discomfort/embarrassment by the nurse/caregiver (11 percent)
- That it is not an issue or there is no reason to (11 percent)
- That the client does not want/can’t talk about it (11 percent)
- Staff find it difficult to talk about (10 percent).
‘And this, while healthcare professionals have a signalling role when it comes to problems and/or questions surrounding sexual health. In addition, it is important that they discuss this topic with patients. This requires knowledge and skills,’ says Ymke. ‘Paying attention to the need for intimacy and sexuality in the elderly is the litmus test for person-centered care,’ adds Noëlle.
Symposium
For 5 years, Rutgers and Vilans have been working to strengthen the topic within elderly care. On November 21 2022, they jointly organised a symposium titled, “Intimacy and sexuality in elderly care” for 130 care professionals in the Bartholomeus Gasthuis in Utrecht.
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