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LATE ADULTHOOD: PSYCHOSOCIAL CONSIDERATIONS

In part, our cultural negativism about sex and romance in the geriatric years is a reflection of an attitude called ageism, a prejudice against people because they are old, that is similar to the more familiar prejudices of racism and sexism in our society. As Butler and Lewis note: “The ageist sees older people in stereotypes: rigid, boring, talkative, senile, old-fashioned in morality and lacking in skills, useless and with little redeeming social value.” These same authors observe that ageism in relation to sexuality is the ultimate form of desexualization: “if you are getting old, you’re finished.”Ageism is not restricted to heterosexuals, either, as this quotation from Gay and Gray: The Older Homosexual Male shows:Many older gay men believe that younger gays react negatively to them. Most older gays feel that young people sometimes take advantage of them, do not welcome their company in bars, clubs, and bathhouses, do not care to associate or form friendships with them, and think they are dull company.It is interesting to note that in a recent study, college students estimated that average married couples in their sixties had intercourse less than once a month and expected that married couples in their seventies had intercourse even less often. As we will see, these are underestimates of actual behavior, showing that young adults are susceptible to ageism in their thinking — at least when it comes to sex.Kinsey and his colleagues were the first to examine systematically the effect of aging on sexual behavior. Although their studies indicated that sex continued well into late adulthood, they also described a general decline in the frequency of sexual activity for both men and women across the adult age range. A number of other studies confirmed these overall trends, with most reports suggesting that the decrease in sexual activity is partly due to diminished health and partly a reflection of cultural attitudes and expectations.More recently, a longitudinal study done at Duke University has found that patterns of sexual activity actually remain relatively stable over middle and late adulthood, with only a modest decline appearing in most individuals. For example, men who were sixty-six to seventy-one years old at the start of this study had no overall decline in sexual activity scores over the next six years, and a majority of men and women in the fifty-six to sixty-five age bracket at the beginning of the study had stable rates of sexual activity during this same time period. However, in those over age sixty-five, 18 percent of the men and 33 percent of the women completely stopped sexual activity with their partners over a six-year period.Various studies of sexual behavior in late adulthood indicate that the male’s declining interest seems to be the major limiting factor to continued sexual activity. This declining interest, however, may say more about cultural expectations which become self-fulfilling prophecies than anything else. While the pattern of sexual activity among aged people varies considerably, coital frequency in early marriage and the overall quality of sexual activity in early adulthood correlate significantly with the frequency of sexual activity in late adulthood.It is interesting to note that most researchers who claim to be studying sexual activity rates in the elderly have actually restricted themselves to studying coital behavior, as though other forms of sexual activity “don’t count.” Many adults over sixty continue to masturbate, although these are almost entirely individuals who masturbated when they were younger. Not surprisingly, elderly people without sexual partners tend to masturbate more frequently. In couples over sixty, other forms of sexual stimulation continue to be utilized (for example, oral sex and manual stimulation); they not only provide some variety, but also can be a source of pleasure and closeness even if the male is unable to obtain or maintain erections. Here is what one seventy-eight-year-old man told us:In my mid-sixties, I had a real problem getting it up. Sexual intercourse became impossible and I got very upset over it at first. But my wife just found other ways to excite me, and after a while — when I relaxed more, I guess — my problem disappeared. Now, even though she doesn’t always want to have intercourse when I do, we still use our mouths and tongues on each other, and we plan to keep doing it, too.In late adulthood, the longer life span of women, combined with their tendency to marry men who are their age or slightly older, frequently creates a situation of widowhood. At the same time that fewer men of the same age are available as new sexual partners, younger men tend to focus their attentions on women under forty. Thus, sexual opportunities and social contacts with men are often extremely limited for these mature women who might otherwise be enthusiastic sexual partners.In the last few years, a new trend is emerging in which not all women in the sixties or older who find themselves widowed or divorced are passively accepting their fate. Some women in this situation are using their ingenuity to find new partners, as shown by the following ad from the personal classified section of a well-known magazine:Tall, handsome intelligent man sixty to sixty-five, wanted for attractive, lively sixty-two-year-old widow with fantastic figure and modern values. If you’re interested in romance more than golf, send a photo and your phone. Box xxx.Although a sixty-five-year-old widow (or widower) may have an interest in sexual activity, social pressures may prevent sexual opportunities or belittle their meaning via snide jokes (e.g., only”dirty old men” are interested in sex, and “dirty old women” should “act their age”). As prolonged abstention from sexual activity in old age leads to shrinking of the sexual organs (just as a healthy arm loses strength and coordination if put in a sling for four months), the older adult is truly faced with a sexual dilemma — “use it or lose it.”An often-neglected aspect of aging in our society is that many elderly persons are relegated to nursing homes or other long-term care facilities for health reasons, to “protect” themselves, or for the convenience4>f their children. Although research on sexual behavior in this population is understandably sparse, a number of authorities have spoken out in favor of making provisions in such facilities (such as making private rooms available) for those who desire sexual interaction. While most nursing home administrators seem opposed to this notion, and some facilities actually insist on segregating men and women even if they’re married, both ethical considerations for protecting the rights of the elderly and more practical considerations having to do with maintaining self-esteem and personal well-being lead us to advocate change in this area. However, it should be noted that permitting sexual expression in the institutionalized elderly is not the entire solution to their plight. Additional steps must be taken to overcome loneliness and boredom in the nursing home environment so that these facilities are not unintentional prisons for our older adults.In the United States, where there is little preparation or education for aging, it is not surprising that many people are uninformed about the physiological changes in their sexual function in their sixties and seventies. They may mistakenly view these normal “slowing down” processes as evidence that loss of function is imminent. Brief preventive counseling during middle age might result in significant change in this area, but changed attitudes toward sex and aging seem even more necessary. What people must recognize is that given good health and the availability of an interested and interesting partner, there is no reason that sexual enjoyment should have to come to an end in late adulthood. Perhaps the ultimate test of whether we have lived through a sexual revolution will be if attitudes toward sexuality in old age are transformed.*102\342\2*

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