Aging and intimacy is a highly debatable topic; especially when you can no longer recognize your loved ones’ behavior.
Geriatric psychologist Melissa Henston provides some insight into aging and sex disorders.
Today I visited my dear grandmother and barely recognized her with her white hair, wrinkled skin and sad demeanor. This once gorgeous and vivacious woman was now barely able to move and confined to bed.
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The culprit? Alzheimer’s disease. With a diagnosis in 2011, shortly after my grandfather — and her spouse of 60 years — passed away, she declined fast, which can be common with this horrific disease.
First she reverted back to her youth and wanted to court men. Then her memory and normal behaviors slowly diminished, leaving behind the woman I knew.
Many of our loved ones seem to change as they age, and there is a psychological explanation for this — whether it’s depression, memory impairment or other age-related factors. With the population of people 65 years and older representing 14.1% of the U.S. population, or about one in every seven Americans, according to the Administration on Aging, many people are watching their loved ones age, change and have increased sexual desires — which can be shocking.
When I had the opportunity to speak with Dr. Melissa A Henston, PsyD, a psychologist who specializes in elderly persons disorders, I was eager to find out more about aging and common health conditions, such as increased sexual desire, that seem to go along with the wrinkles and latter years.
Read our interview to gain insight into aging and normal sexual tendencies as well as specific health conditions, such as Alzheimer’s and dementia, which can sometimes alter sex drive.
Having a grandmother who suffered from Alzheimer’s in tandem with working in a nursing home practice, Dr. Henston decided from a young age that her primary focus in psychology would be issues in aging:
“People are the same as when they’re younger; emotions can just be heightened and health disorders can change things,” Dr. Henston says.
She adds, “There is no manual for aging. People sometimes need help with life and social stress. For example, people are excited for retirement. They look forward to free time with no scheduling. But after the first six months — after they’re done with all the cleaning and organizing — things can change.”
Dr. Henston explains that many people don’t know what it’s like to be an active or engaged senior. For example, when a spouse retires, a daily routine and marriage dynamic for a couple completely changes:
“It’s normal for a wife to get frustrated when all of a sudden her partner is home. It’s more stressful as she all of a sudden has to do more cooking and cleaning, and her regular schedule is drastically changed. The husband who is now home from work has to learn how to adapt to a completely new lifestyle that doesn’t involve a 9-to-5 job, which can be really difficult for some people. They just don’t know how to engage socially when they’re not at work.”
Dr. Henston had a Mormon patient who struggled with her newly retired husband exclaim, “We are sealed for eternity; do you know what that means?!” The seemingly comical acknowledgement was telltale of many aging couples’ frustrations that Dr. Henston has encountered throughout her practice.
These relationship problems — that usually occur in our 60s to 70s — can add to other problems that are a normal part of aging, such as health conditions and diseases.
Like elder love and relationships, sex can also be a sensitive subject as people age, though Dr. Henston points out that it’s a normal one.
“Sex is a very regular conversation as people are still sexually active as they age — or they want to be.”
Dr. Henston spoke with one couple that had been married for 40 years, but had not had sex in 20. Dr. Henston spoke with the husband about how to have a conversation with his wife to increase their happiness and intimacy. But the wife’s response was surprising: “Certainly you don’t mean sexually? I thought you were gay.” The couple had been married for so long and the question had not been asked, creating more of a problem. Dr. Henston had to counsel the husband on next steps to a healthy relationship.
“Unfortunately, sexuality is still confusing and taboo — even for the family. I’m hoping the topic is not an issue with the next generation,” comments Dr. Henston. “It’s a healthy part of aging and relationships.”
If someone has Alzheimer’s or dementia, relationships can be even more confusing. Hypersexuality, which is what happened with my grandmother, is one form of dementia that can occur where a person suddenly has increased sexual urges. Families and societies have to confront how to deal with this disorder. Though, according to Dr. Henston, this is a touchy subject.
“How we deal with hypersexuality can be very difficult. If the person is still a consenting adult and indicating signs of pleasure, it’s deemed acceptable. But there are other things to consider.”
Dr. Henston discusses one of the situations she encountered in her practice where the wife suffered from dementia. The couple had been married for seven years and it was the second marriage for both. “The husband was visiting his wife in her assisted living community and they were having sex on these visits. But the wife’s daughter had a problem with this as she didn’t feel like her mother was a consenting adult,” notes Dr. Henston. “The husband was arrested and the case went to court. It was determined that as long as the wife was indicating signs of pleasure, the husband should not have been arrested.”
Dr. Henston notes a couple things to consider in the case of memory impairment:
1. Is the sexual tendency a new behavior, or was the person sexual in nature before memory impairment?
2. If the person is deriving pleasure, should we stop it?
In the case that the elderly person lives in assisted living:
1. Is the senior living community aware this behavior is going on?
2. Is safe sex being practiced?
Dr. Henston comments that some of her doctoral students at University of Denver visit nursing homes and ask the administrators, “Do residents practice safe sex in the nursing home?” The director will usually either shy away from the question or have a dumbfounded look, and many will say, “We do not have sex in our nursing home.” But Henston notes, “This is not true. The question should be, ‘how is the assisted living facility managing sex since it’s a normal human practice.'”
As much as caregivers may prefer seeing older adults as asexual:
More than half of men over age 60, and 40% of women, remain sexually active, according to the Centers for Disease Control and Prevention. In 2007, a federally funded survey found that nearly a third of sexually active 75-85-year-olds gave or received oral sex.
STDs do exist in nursing home environments, which is why it’s even more crucial for facilities to confront the issue. Some assisted living communities have developed rules regarding intimacy specifically for married couples, so if there is a married couple where one or both of the spouses live in the community, they can have privacy and practice safe sex. Many communities are also starting to acknowledge the need for better policies relating to this hot topic.
Aging healthily requires a combination of healthy living and lifestyle choices. Sex is a normal part of aging and life that Dr. Henston addresses in her practice – and she believes more people should be having a discussion about it.
“It may be an uncomfortable conversation, but it’s part of life and often something caregivers need to address. Society and assisted living communities need to confront these difficult topics.”
Dr. Henston performs standard neurological assessments on new patients that have “norms” based on specific ages and education levels. These assessments can help determine whether the senior suffers from specific memory impairment disorders, which are also markers in specific behavioral changes, such as increased sexual tendencies. Sometimes people revert back to their youth with diseases like dementia and Alzheimer’s, giving them a higher sexual drive, Dr. Henston says:
“Always think of memory being erased backwards. Peoples’ most recent events will decline first. The reminiscence bump is a term for the strongest memories being from age 15 to 30, when coming out of adolescence into adulthood — these are our most resilient memories.”
My grandmother suddenly wanted to be courted by men at 87 as her brain had traveled back to her more youthful state when she was more sexual. Her case was one of Alzheimer’s memory impairment, but many seniors still want to live life to the fullest and engage in intimate relations.
Engaging in a social, stimulating lifestyle is recommended as we age. But sex is also a normal part of life that needs to be addressed.
Dr. Henston comments, “People need to look at intimacy for what it is: a normal human tendency that needs to be discussed, not swept under the rug.”
Dr. Melissa Henston is a geriatric psychologist in private practice with Colorado NeuroBehavioral Health, where she helps seniors and caregivers understand and navigate physical, cognitive and mental health changes. Additionally, Dr. Henston is a professor at the University at Denver, Graduate School of Psychology, where she teaches “Aging and Geriatric Psychology” to doctoral students.
Dr. Henston’s philosophy is that getting older is a unique process that requires self-acceptance and awareness to life values in order to achieve successful aging. She has worked with the Alzheimer’s Association, presented at conferences on aging, and lectured at the University of Colorado Health Sciences Center. She diligently works with families who are facing problems that may develop as parents transition into needing more care, and performs neuropsychological evaluations on older clients to help them understand cognitive issues that can arise with aging.
Have you or a family member experienced any of the aging and sex issues Dr. Henston addresses above? What do you think senior living communities should do for seniors who still desire intimacy? Share your thoughts in the comments below.