Sexuality is a broad term that encompasses sexual identity, activity, attitude toward sex, intimacy, partnership, and pleasure. In this podcast, we cover the basics of sexual function and the effects of aging, medical comorbidities, and mental health on sexuality. We discuss sexual health in long-term care settings and in older adults with cognitive disorders and suggest an approach to commonly encountered sexual health issues.
DR JAIN: Sexuality is a broad term that encompasses sexual identity, activity, attitude toward sex, intimacy, partnership, and pleasure. In this podcast, we cover the basics of sexual function and the effects of aging, medical comorbidities, and mental health on sexuality. We discuss sexual health in long-term care settings and in older adults with cognitive disorders and suggest an approach to commonly encountered sexual health issues.
Welcome to The Carlat Psychiatry Podcast.
This is another episode from the geriatric psychiatry team.
I’m Neha Jain, an Associate professor of psychiatry, Medical Director for the Mood and Anxiety Disorders Program and Associate Program Director for the Geriatric Psychiatry Fellowship Program at the University of Connecticut Health Center, in Farmington, CT.
In today’s podcast, I am joined by two of my colleagues.
DR COLLIER: I’m Stephanie Collier, The Editor-in-Chief of The Carlat Geriatric Psychiatry Report.
DR AZIZ: and I’m Dr. Rehan Aziz, an associate professor of psychiatry and neurology at Hackensack-Meridian School of Medicine. I am also the associate program director for geriatric psychiatry and general psychiatry at Jersey Shore University Medical Center, in Neptune, New Jersey.
Let's begin our discussion with the topic Dr. Jain started out with. What are your thoughts about how sexual function and sexuality intersect in older adults?
DR JAIN: Yes, first it is just important to acknowledge that older adults are sexually active because discussions about sexual issues are often avoided in healthcare settings. You know there is often discomfort on part of the patient or clinician, a lack of knowledge-I mean how much training do you remember in Med School and residency about sexual heath-right? Or a fear of embarrassment, or just plain ageist beliefs. However, a fulfilling sex life is a crucial aspect of quality of life for many seniors.
DR COLLIER: It makes a lot of sense, the question is how do we bring this up when we are talking to our patients and assessing their sexual heath in clinical settings?
DR JAIN: So, I tend to start first by just asking permission. You know, is it okay if I ask you a few questions about sexual health or sexual activity? Then I ask more open-ended questions, like do you have any concerns or questions do you have in terms of your sexual activity? Or, have you noticed changes in your sexual relationship with your partner over time? Many older adults will not disclose sexual health issues if there are others in the room, so I of try to ensure privacy when screening for sexual dysfunction. I ask about problems with libido, getting/maintaining an erection (for men), dryness or discomfort (for women), and for all genders difficulty achieving orgasm.
DR AZIZ: Dr. Jain I had a question for you regarding that, so my experience is I will usually have patients come to the office.. and if they are accompanied by a patron there is no issue about asking about sexual function/activity, but often they are coming with caregivers or their children. And then it can become quite uncomfortable to ask them these questions. How do you handle those situations?
DR JAIN: Absolutely, and first of all, I would say don't. You know, so do not ask the question if there is anybody other than the partner, and even sometimes when it is the sexual partner that is present, some people may not feel comfortabl. Usually, I try to sneak in at least some private unites with the patient, and I can just say to whoever is with them, I would like to ask...