The Elephant in the Room – A Critical Interpretive Synthesis of Older Adults’ Sexuality

Abstract

Objectives: This study aimed to explore past studies that have focused exclusively on the sexuality of adults older than 65 from a positive public health approach. Methods: We performed a critical interpretive synthesis, starting with the literature review on sexual behaviors in later life, adding policy documents on aging sexuality, and bringing new perspectives. Results: Older adults continue to be sexually active. Healthcare professionals lack knowledge and communication skills surrounding aging sexuality and no policies before 2013 mention aging sexuality. Conclusions: We posit that society's view of later life sexuality reflects on practice, policies, and research on this topic, which influence back society's view.

Sexual Activity and Physical Tenderness in Older Adults: Prevalence and Associated Characteristics from a Belgian Study

“…Healthcare professionals therefore need training to increase their comfort with raising this topic with older patients, and sexual education programs should focus on different ages, not just on youth 11 . Policies, practice, research, and society all influence each other 9 , and a more positive approach to sexuality in older adults is needed to increase acceptance of sexuality in later life. Our findings provide further support for previous recommendations that healthcare professionals need training to reassess their beliefs about sexuality in later life and improve their communication with older patients on this topic 11 .…”

“…Older adults have expressed a desire for healthcare providers to pay more attention to sexuality in later life 7 and provide help if needed 8 . However, studies have shown that healthcare professionals lack knowledge and communication skills on aging sexuality 9 , that older patients' sexuality is considered outside the scope of practice 10 , and medicine-based treatment plan regarding sexual dysfunction is recommended to older patients, compared to the therapy treatment plan recommended to younger patients 11 .…”

“…Previous research suggests that sexual activity in older adults is often underestimated if only the frequency of sexual intercourse is taken into consideration, as other types of sexual expression are relevant to older adults. Therefore, our study involved questions regarding both sexual activity and physical tenderness 9 .…”

“…Previous relevant studies in Belgium have mainly assessed older adults aged ≤ 75, and the oldest participants worldwide have only been aged up to 80 or 85 years 9 . To the best of our knowledge, no previous studies have explored sexual activity and physical tenderness among adults aged > 75 years in Belgium 23 or worldwide among adults aged > 85 30 .…”

A Systematic Review on Psychological Interventions for Sexual Health in Older Age

“…On the other hand, findings suggest that having a fulfilling sexual life is beneficial for health and quality of life (T. J. Flynn & Gow, 2015 ; Smith et al., 2019 ; Willie-Tyndale et al., 2021 ; Wright et al., 2019 ). Maintaining sexual desire and sexual satisfaction in older age was linked with multiple dimensions of well-being (Buczak-Stec et al., 2019 ; Jackson et al., 2019 ; D. M. Lee, Vanhoutte, et al., 2016 ; Smith et al., 2019 ) and successful aging (Štulhofer et al., 2018 )., thus underlining the importance of adopting a more positive approach toward sexuality and aging, namely including sexual health and pleasure, for promoting well-being in later adulthood (Cismaru-Inescu et al., 2022 ; Sladden et al., 2021 ; Syme et al., 2019 )…”