Older Adults and Sexuality

The majority of my blog posts focus on how I infuse my professional passion for counseling and sexual health in my personal experience as a parent. Today I shift gears, and I give you a glimpse of some of the work I am doing with older adults on the topic of sexual health. 

In 2007, I embarked on a career that would forever change my life. I began working with older adults in low income housing. My work focused on case management, advocacy, increasing self-sufficiency, and reducing early institutionalization (long term nursing care) of older adults. It was love at first sight! How did I not know how incredibly amazing our older adult generation was until now? Working with older adults was the best decision I ever made. I learned older adults are vibrant, energetic, empowered to learn, and full of wisdom. I wanted to fuse my passion for working with adults throughout my career with my practicum placement at Turner Professional Group, therefor I created a graduate project around these two themes.

Throughout this past year I have developed a psycho-educational group entitled, Sexuality and Aging. It’s like Sex Ed 101 for adults 65+. The intent of this assignment was twofold. The first was to empower older adults to start a conversation, and begin communicating thoughts and concerns about sexuality in a safe environment. The second was to provide educational information on sexually transmitted infections, HIV, and AIDS. It wasn’t easy convincing people to let me, a student, come in and discuss the issue of sexuality and aging. I found a fair amount of resistance, further convincing me that SEX is a dirty word (but shouldn’t be!) and the idea that older adults don’t need to learn about sexuality (but they do!). So, after begging and pleading to some extent, I managed to get my program out into the community through a few trusted colleagues. Together we learned that those in attendance really enjoyed talking about sexuality! With my sex positive attitude, I managed bring comprehensive sex ed to three housing communities for older adults.

Where did I begin you ask? A simple Google search brought me to two very important issues. As I began my research I was quickly thrilled to learn that older adults are still getting jiggy with it! Surveys by AARP and the CDC found that older adults continue to have fulfilling sex lives well into their advanced age! With (and often without) medical intervention and simple accommodations to our changing physiology we can engage and maintain a healthy sex life, almost indefinitely. This lead to equally intriguing research in the incredible spread of sexually transmitted infections with this population. So…from these two fun factoids I gave birth to a brief one hour psycho-education presentation on SEXUALITY and AGING! 

I was over the moon when I walked into my first presentation and we had to bring in more chairs! I was particularly excited to have men enter the equation on my second presentation, and boy did they challenge me! Barking up and down my tree tell me a thing or two about sexuality. What is so incredible about working in the community is that you get the thrill of never know who your audience will be. I had a few very highly educated feminists, members of the LGBTQ community, and ultra conservatives, all from a variety of different cultures. Most of these folks came from a generation that did not receive comprehensive sex education and from an era where you didn’t discuss sex. Our society has created a sex-crazed culture, yet a critically silent approach on sex education. We don’t know what we don’t learn…IT’S A CONUNDRUM!

A large part of the presentation with this population was to break the silence. To empower adults to take their sexuality by the reigns and engage in it. So many of our older adults are already isolated, and silence contributes to AGEISM. Ponrat Pakpreo, the author of Medical Evaluation: Why we take a sex history, discloses low rates of sexual health assessment by physicians and other health care professionals. A variety of barriers are admittedly shared by physicals including: time constraints, underestimation of patient risk, lack of information, and embarrassment. These barriers prevent some clinicians from conducting sexual assessments (Pakpreo, 2013). I found this to be true in each of the presentations I gave with older adults. In a nonscientific experiment (show of hands), the majority shared that their primary physician doesn’t asses their sexual health. They admittedly agreed that they too as patients don’t disclose to or ask questions about their sexual needs with their primary care physicians. Empowering older adults to be their own advocate with their doctors was a crucial message to share. 

Building new perspectives on tolerance and respect to gender roles and stereotypes in this population was also an important message.  We dove into all the circles of sexuality…intimacy, sensuality, sexual health/reproduction, sexualization, and sexual identity (Dailey, 1981). With age, many of these can vary with intensity, however they continue to exist. My favorite part of these talks was hearing the love stories they had to share. Loving and losing was a theme that was shared each and every class. I encourage all of those reading this to engage with a parent, grandparent, or older adult about their love story. Their wisdom is worth its weight in gold. 

Informing facts of STI/HIV…

The presentation sought to inform adults 55+ that they are a high at-risk group for sexuality transmitted infections as well as HIV/AIDS. Data from the Centers for Disease Control state that this age is just as at-risk as young Americans. Older adults ages 55+ make up 19% of the populations living with HIV (Centers for Disease Control, 2013). In addition, sexually transmitted infections (STI’s) are on the rise in adults age 50 and over, 50% in fact (Centers for Disease Control and Prevention, 2013). 

We know that adults 80+ years are sexually active and we know sexually transmitted infections are on the rise! What is happening? I will tell you what’s happening…the baby boomers and beyond are physically active, sexually spirited, and bursting at the seams! Truth: less than 1/3 of the surveyed adults used a condom during their most recent sexual encounter (Schick et al. 2010). We are talking about 80% of sexually active older adults not using protection! Many older adults believe the myth that they are exempt from STI’s is wreaking havoc and must be stopped! A fantastic PSA from safersex4seniors.org, provides a very impactful message to free spirited sexually active older adults. See full PSA at this link: https://youtu.be/1Pfa07ijUCE. 

What I learned…

It was refreshing that I was able to connect current research that tells us that older adults are sexually active, with a unanimous response from my classes that they are also very excited to talk about sex. We are breaking the silence and addressing concerns and issues related to sexuality and answering the health questions and providing resources in order for older adults to get them help them need.

I am happy to report to all my dear readers that despite your age, size, and physical ability, a person’s need for affection, desire, and pleasure extends well into advanced age…to our last breath really. There are hundreds of ways to engage in sex…please remember to increase your safety by using a condom! For help or assistance in safe contraception please contact your doctor or wellness provider. 

Special thank you to Phoenix Family (www.phoenixfamily.org) for their continued support of my work with older adults and allowing me the privilege and trust to present Sexuality and Aging to the following communities: Landmark Towers, Nowlin Hall, and Cathedral Square Towers. 

Citations:

Atlanta: U.S. Department of Health and Human Services; 2013.

Centers for Disease Control and Prevention. Factsheet: HIV among older adults November

2013. Retrieved at www.cdc.gov/hiv

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2012.

Dailey, D.M. (1981). Sexual expression and aging in F.J. Berghorn & D.E. Schafer (Eds.). The dynamics of aging: Original essays

on the process and experiences of growing old (pp. 311-330. Boulder, CO; Westview Press.

Fortenberry, J. D. (2010), Sexual Behaviors, Condom Use, and Sexual Health of Americans Over 50: Implications for Sexual

Health Promotion for Older Adults. Journal of Sexual Medicine, 7: 315–329. doi: 10.1111/j.1743-6109.2010.02013.x

Pakpreo, P. (2013, October 1). Medical Education: Why do we take a sex history? Retrieved

November 10, 2014, from http://virtualmentor.ama-assn.org/2005/10/pdf/medu1-0510.pdf
Schick, V., Herbenick, D., Reece, M., Sanders, S. A., Dodge, B., Middlestadt, S. E. and

Teachable Moment: Approachable Parenting Part Two and my "First Kiss"

Teachable Moment: Approachable Parenting Part Two and my "First Kiss"

Last blog I introduced the new-cool-hip attitude to parenting called approachable parenting or also referenced as being an askable parent. My style is proving day in and day out, that yes, I am an approachable parent. Proof in the last few days, I fielded all the following questions from the humans in my household:

Female age 7: How did my little baby cousin come out? What did it feel like? Do I have a hole for that, or does it grow when I have a baby?

Male, age 9: Should I be wearing a nut cup? Maybe I can borrow dads until I can get one?

Male age 40: How can I make it through all this puberty stuff without a nervous breakdown? Female age 11: It is ok if I video chat online with boys, cause I have an online date? How old do I have to be to go on a real date? Mom, my friends are kissing already can you believe that? When was your first kiss?

I will honestly admit that I wanted to crawl in a hole and never come out. It was like a barrage of bullets, each hitting me hard where it counts: the heart, the gut, the frontal lobe. All three of those organs had a different opinion and response to each question. I was also managing some pretty lengthy graduate assignments this past week. I didn’t have time, and truth be told, I did not want to talk about this stuff!!!

I have had prouder moments as a parent; I wanted to dismiss the interrogations and run away with a very tall glass of wine. Like an esteemed politician, I put on my game face and responded confidently. It was the questions from my oldest daughter that got to me the most. Since we have already had the big talk about sex, pornography, and gay/lesbian/queer due to the Google search drama, I thought surely she needed a break. This is all really heavy stuff.

Oh no, this can of worms was officially opened. Here is how it went… It is important to know much of this was narrated in my head… and what words came out were mostly a bunch of stuttering…When my child asked me to divulge the details of my first kiss, I remembered it was not the millisecond peck on the lips kind of kiss, it was the real deal, the insert tongue-in-mouth kinda kiss. The whole adage “do as I say not as I do” came to mind. I always told myself I wouldn’t lie to my kids, but in this moment I wanted to lie. Surely a few Hail Mary’s and a half dozen Our Fathers would do get me outta this one? No, I promised I would use my experiences as ways to engage and connect intimately with my daughter. She can handle it. I told myself I don’t have to go into detail, but I will be truthful.

I will admit it was pretty dreamy thinking back to my first kiss. I remember planning it for weeks, maybe months. It was a rite of passage that I took very seriously. “It was the summer after my 8^th grade year, I was about to be in high school and desperately wanted to be kissed. He was a few years older, and I am pretty sure I was not even close to being on his radar. I will never forget I was wearing braces. It was nice, wet, and thoughtful, and I am sure it didn’t last nearly as long as I remember.”

Ok, done. I thought I handled that pretty well. Not too much, just enough to appease her, right? Regret immediately sinks in. “Do you remember this boy? Like did you ever see him again?” she asked. “Of course! That would be pretty irresponsible if I planned this great kiss with some random kid. We were friends, and as a matter of fact we are still friends to this day.” After a few more details about how this “boy” was, we were laughing and giggling together.

The boy, well he remains a constant reminder of just how giddy we gals can get at such a young age. More importantly, it is crucial for us parents to recall our experiences and what we went through in order to relate to our children.

My friends and I have a running joke about mothers with “momnesia.” That is the idea that we easily forget about the mistakes we made as youth, and our distorted sense of the past becomes “I never did anything like that”. My own parents do this more than I do, but they have many more years separating them from puberty than me. For me, recalling my past helps normalize my child’s behaviors and experiences. As I reminisced conquering my first kiss, I asked myself, is this what I want for my daughter? The pragmatic sensible parent in me was thinking, “it would be great for her to have a similar intimate moment with a boy in which she can feel proud, and furthermore recall with a sense of pleasure and fondness.” The important thing is that I can talk to her about it, and if and when she decides to engage in kissing or whatever intimate experience, she will talk to her “cool, approachable, hip” mom before it happens. And at that point, I will want to do my damnedest to talk her out of it until she is 18! Because let’s be real, the mama bear in me thinks I will have no young cavalier boy lip locking with my baby girl. Whoever this little punk is, he’s going to get a tongue lashing in more ways than one! The truth is, finding the balance on how we can influence our kiddos to make the right choices, and trust that they will do so, is hard.

I won’t lie, I had my kids watch an episode of the TLC reality show, 19 Kids and Counting, the one when Jill starts courting and they set courting rules like only side hugs, a chaperone on all dates, and no kissing til marriage. I admire the Duggar family values, I do, and I would support my child in that decision. I also know that growing up with all the temptations in this world make it difficult to adopt this philosophy. I fully embrace my child making mistakes and likely choosing to do things I prefer she not do.

Lessons Learned: How can we embrace the evolving levels of attraction our kiddos are experiencing? I talked about being an approachable parent in my last blog, and this past week continues to support my philosophy to engage with my kids especially so they can learn from my past. I have to share her response to my first kiss story:

“ehhw really, braces mom? That’s gross! Please tell me you didn’t look anything like Sara, (Jimmy Fallon) in the “EW!” videos. Do braces make you slobber like that? I am sure that was sooooo unattractive.”

The two of us have agreed to talk openly. We continued this conversation over time weighing the pros and cons to courting and dating. We are reading “Before you meet Prince Charming” a book that talks about purity, as she is already discovering that her values and morals are important to her. I think it is important that we don’t underestimate our kids’ ability weigh risk and reward especially when they have a supportive adult willing to listen. In these moments remember to give facts, and do not pass judgment. I think it is so crucial that we also don’t assume our tweens and teens are naïve. I know I am not naïve, and despite talking about purity and abstinence, I will also have conversations about contraceptives and pleasure. I struggle in times like these, and find myself responding to my fears and worries. In that struggle, it is easy to forget about the question they are seeking guidance on, so respond to your children, tween, and teenage not from a place of dread or burden, but of honesty and with factual information.  

Do you consistently brush off moments when your kid asks a question you can’t answer? I know everyone who watched the World Series with their kids got asked what erectile dysfunction is. Yowsa! It isn’t too late to overcome your coyness. Start with a strong, open, honest heart. I think our kids have a pretty great chance at success in this crazy thing called life if we stand by them all the way! 

Teachable Moments: Approachable Parenting "How to talk to you kids about...."

Teachable Moments: Approachable Parenting "How to talk to you kids about...."

In a blink, my youngest child has morphed from this innocent creature we call a child, into a mysterious alter ego who stands looking at me with no longer an inquisitive eye, but a sneering death stare. It’s almost my worst nightmare…it’s a tween! Not a kid and not a teen, but a very confusing time when the body and brain is on fire with hormones and changes! It would be remiss to say that it doesn’t get worse, as this is just a prequel to the dreaded teen years. 

As a parent it is thrilling and devastating watching your sweet, naive child grow into a young women overnight! How did we evolve from picking out My Little Pony underwear to bras with actual cup sizes? I begrudging let go of the days of writing notes from the tooth fairy, seeing the look of joy on her face  as she holds a shiny silver dollar in her hand like it’s worth millions. I want to strangle “prepubescence” in its wicked manipulative state, and beat it to a bloody pulp…no pun intended. Since there is no stopping this monster taking over my child, I devise a plan that will allow me to manage it. A plan for my child to learn not to be afraid of it. At the ripe age of 10, in the 5th grade, I knew it was getting close to the time that all innocence would fade away. Sure enough by the summer after, we had our first “inappropriate video” come up one of our electronic devices. My daughter searched “twerking” after hearing the buzz word from conversation amongst, adults no less. If you don’t know what twerking is, Google can provide you the answer, and more. Go ahead type it in now...it will help support my point that with less than 3 or 4 clicks on the Internet, with even an innocent search, is a source for all things good, bad, and ugly. She learned about twerking and much much more. In less than just a few clicks, twerking will take you to some pretty illicit pictures to some very illicit videos. I know you’re all thinking “well if you had parental controls that wouldn’t happen” and let me be the first to tell you, parental controls do not provide all the safety net you would think. In our case, it was an iTouch that lead to the illicit video through the app Pinterest (more on this to follow).  We thought we had the devices all locked up tight, but alas there are about so many worm holes in that damn device and our kids (globally speaking) know how to find them. It’s not that our kids are deviant or unruly…they are curious and smart. I don’t believe my daughter was at fault for this situation. She didn’t know she would find pornography (she didn’t know it existed at the time), but she fell prey to her curiosity and her curiosity won. I knew in this moment I had to be an open, honest parent. I decided right then and there that I would not lie. I would provide her the facts and give her the support she needed to understand what she saw, changes going on, and how to move forward from there. 

Lessons learned: Kids learn the hard way too. Sadly when it came to twerking, I was not available to her to ask the question or my daughter didn’t feel I was approachable to ask.  Guess who was available for questioning? GOOGLE. This situation gave birth to a new parent-child relationship. Approachable parenting, or what I like to think of as preventative parenting. Those moments where your gut tells your kid has a question and isn’t asking, or you have the gut feeling to get it in your kids head before someone else does. Concepts like separation, divorce, Santa Claus, sex, the friend with two mommy’s are difficult to broach. 

Would you rather your kids learn about them:

A)        On the school bus form the obnoxious older sibling of your kids best friend?

B)        Their friend who cries to them on the playground their parents are breaking up?

C)        Google

D)        Textbook in 6th grade health class?

E)        A parent or guardian who has the good sense to tell them the truth, and who love them?

Answer: E. My best parental advice is you do the talking, and talk openly and talk OFTEN! Don’t rely on anyone else to educate your child on the greatest lessons on life. Surprisingly, kids are willing to talk and want to talk about these heavy topics. Both my personal experience with my kiddos, and professional experience in counseling have proved this to be true. Research has indicated, time and time again, that open and regular communication to our kids about sex, sexually transmitted disease, condoms, drug use etc. result in less risky behaviors than over those kids who do not have someone who communicates openly. Don’t believe me, read it yourself: http://www.advocatesforyouth.org/the-facts-parent-child-communication. 

A great series of books by Robie Harris can help with all these hard issues. It’s Perfectly Normal, It’s So Amazing, and It’s Not the Stork are just a few of my favorites. I learned the birds of the bees from “Where Did I Come From” by Peter Mayle. It was great for teaching the basic fundamentals of how babies are made…but honestly that is the easy part. The hard stuff is puberty, hormones, gender stereotypes, masturbation, pornography, wet dreams, relationships, intimacy, when to wait, and LGBTQ questions. Robie Harris books will guide you and your child through this process with developmental messages that are healthy, humorous, and appropriate. Don’t make it a big deal, but make it a priority.

*Parental control tip: Apple products have a control setting in which you can set up apps by age. This is a good start to only allowing your kids age appropriate material. Even though we blocked the internet from our kids devices, we didn’t block it. Most apps have the ability to access the internet. Pinterest, an app we allowed under my account (so I can see what is pinned) has the ability to open a window and search the WIDE WORLD WEB at your heart’s content. This was one loop hole I was unaware of, and I am an avid Pinterest user. 

Teachable Moment: Outsmarting Smartphones!

Teachable Moment: Outsmarting Smartphones!

You couldn't pay me to be a tween or teenager in this era. I will age myself by saying this, but I am glad I grew up in a time when you only had Saturday morning cartoons for 2 hours, and the TV went out at midnight with the national anthem signing off til morning. A time when you found your friends based on a mountain of bikes huddled at a park or someone’s driveway across town. I helped chaperone a birthday party for 14 tweens recently, for a birthday girl who was turning 12. The girls were hanging out to watch movies and eat junk food. You can imagine no one watched the movie and all the junk food was gone in a matter of moments. For the most part the “drama” was low for a room full of raging prepubescent females, and there was no shortage of screams and giggles. There was also no shortage of comparing Facebook, Instagram, and status updates. The only squabble was an Instagram post that innocently missed a few girls in the screen. Subsequently they demanded a retake and repost of the entire group.  “It’s not fair to be left off and not tagged appropriately” one of the girls demanded! As I surveyed the room more than half were texting or fiddling with their smart phones (not a single flip phone in the bunch!) even texting “secrets” to each other from across the room. After the fourth tattle-tale came to me expressing her fury around girls texting their so-called boyfriends and not hanging out, I decided to intervene. I grabbed a basket and proceeded to confiscate the iPhones for the remainder of the party. I collected 12 iPhones and one iTouch. Of the 14 gals at the party, only one did not have a cell or electronic device….and that was my daughter. This is not to boast, as at times I have felt insecure from parents shaming me for not providing my child a phone for “safety” reasons, (this is complete BS if you ask me!) but my husband and I have been pretty clear on our position on smart phones. (We have learned from experience the risk involved in our kids accessing misinformation. Not to mention the cost, responsibility around damage and loss, and the idea of receiving and sending out inappropriate pictures…but that is an entirely separate blog post to look forward to!) I digress, back to the shocking look on my daughter’s face which was initially out of pure embarrassment. Admitting she had nothing to add to the basket, then a brave and emphatic “why play with my phone when I am with my best friends” fell off her lips. I cried a little inside, then quickly had to manage crowd control over the cries and stink-eyes glaring back at me. One gal actually said “I can’t be without my iPhone my parents will be upset if they can’t find me” to which I responded with the same stink eye and a playful "be a good sport and give up the phone.” 

Lesson Learned: The first maybe 1 minute 30 seconds after taking the phones away were painful, only because they resented me. After that fun and frolicking ensued and the kids sat together and played games! I rounded up 10 of the 14 girls to play a simple game resembling the old classic, telephone, around the dining room table. Laughter results and memories began to blossom around me, and not one of the girls asked for their phone before their parents picked them up. While I am a very progressive individual and parent for the most part, I am incredibly nostalgic and wistful about living in the moment. I find sheer joy in savoring friendships and building memories. In this age of social media and technology kids are less likely (as are adults) to pick up the phone to call someone. Instead, they look at Facebook to see where people are “checking in” in order to find their friends. I challenge all parents to help their child build healthy boundaries around social media and use it for good and purposeful activities. It can be as simple as throwing electronics in a basket for an hour at a time, but more importantly it is our job as parents to engage with them and model those crucial social skills to build healthy friendships with their peers. If nothing else, I guarantee you will minimize hurt feelings, addictions to social nonsense, and bullying with the simple notion of putting the smart phone down. If you too have your smartphone in your hand and are posting every last move you could use a breather as well. So take the plunge together!

For more information on building healthy boundaries around social media and smartphone use for parents and teens visit:

http://www.safesearchkids.com/parents-guide-to-protecting-teens-on-social-media/#.VKsMs_ldWgw 

http://www.psychologytoday.com/blog/teen-angst/201312/smartphones-teens-101

https://www.lookout.com/resources/reports/smartphone-family-guide