The Best of…Sexuality Continues Throughout Life

Published August 21, 2001, Pawtucket Times

          Many seniors consider sexuality a very private matter.

          But just after the wonder pill Viagra hit the pharmacy shelves across the nation in the late 1990s, sexuality in later life became literally the talk of the town.

          From articles in daily newspapers to late night talk show monologues, to conversations with family and friends — we talked openly about sex, may be just joking about the miraculous powers of the little blue pill with the intent to relieve our own personal discomfort of the taboo topic.  But Viagra was not a joke to tens of thousands of older persons who were able to become sexually active again.

        But even today, this writer still hears snickers from some readers who believe that seniors are asexual, and that six is of no interest to them in the twilight years of their lives.  It’s a myth, experts say, their observations supported by two nationally released research studies that indicate that sexual intimacy between seniors is alive and well in the United States and still important to those in their later years.

       Don’t believe in the misconceptions and stereotypes that older people are asexual beings and that a person’s sexual needs quickly evaporate after they reach age 50, says Tamara Kreinin, president of the New York-based Sexuality Information and Education Council of the United States.

       “People are sexual beings throughout their lives,” Kreinin stated, adding that sexuality is a natural and healthy part of a person’s life.

        Seniors do enjoy sex in their later years and it can enhance a relationship and bring couples closer, Kreinin noted.  “You must not view sexuality as just intercourse,” she warns, because it has a wide-range of behaviors.

       For Instance, touch can be an important part of a person’s life.  Sexuality can also range from an embrace, a kiss, to intercourse, Kreinin added.

       Adds Kreinin, today’s culture is focused on youth and sexuality but for many older people their sexual pleasure has increased over the years because they have become more comfortable with themselves and their intimate relationships.

      According to Dr. David Kroessler, a geriatric psychiatrist and clinical assistant professor at Brown University in Providence, one’s sexuality is an integral part of human behavior.

       “Sexuality activity does not stop after you’re 50,” Dr. Kroessler says, noting that this can sometimes be news to a low of people. “Younger people tend to think that sex is just for the young and they just can’t imagine their grandparents in their early 80s having sex.  It’s not expected,” he noted, adding that many seniors in their later years, especially males, still have a strong sex drive.

     “If someone is asexual as a younger person, they don’t develop into a more sexually promiscuous person when they become older,” Dr. Kroessler said.  A person’s style of sexual behavior tends to remain constant throughout the life span, he says.  “If sex is not frequent when you’re younger, it will definitely be less frequent when you are older.”

      What does the national research tell us about sexuality and seniors?

      According to 1 1998 National Council on Aging (NCOA) research study, half of Americans age 60 and older report that they are sexuality active, while four in ten want sex more frequently.  The random NCOA survey of 1,300 older Americans was conducted by Roper Sarch Worldwide.

       The NCOA study also found that men and women in their 60s are more sexually active than Americans in the 70s (71 percent of men vs. 51 percent of women in their 60s, 57 percent of men vs. 30 percent of their women in their 70s).

        The survey results revealed that more older men than  women said they are sexually active: 61 percent of men and 37 percent of women. This gap results, in large part, from the longer life expectancy of women, the researchers say.  Older women are more likely to be widowed and no longer have a partner.  The higher ratio of women to men increases with age.

      Meanwhile, the researchers said that sexual activity continues to play an important role in relationships among older men and women.

       Among those respondents who said they are sexually active, 79 percent of older men and 66 percent of older women said that maintaining an active sex life is an important aspect of  their relationship with their partner.  When asked about the emotional satisfaction they get from their sex life, 74 percent of the sexually active men and 70 percent of the active women said they are as satisfied or even more satisfied than they were in their 40s.

        While more than half of all respondents said they engaged in sexual activity less than once a month, 54 percent of these men and 26 percent of the women said they would like to have sex more often.

        While sex is viewed as important, so is romance, researchers say.  Nine out of 10 respondents identified a high moral character, a pleasant personality, a good sense of humor, and intelligence as important qualities in a partner.

       In addition, a 1999  AARP Modern Maturity survey revealed that Americans age 45-plus have not lost that “loving feeling.”

       The mail survey was sent to 1,384 adults aged 45 and older in March of 1999 by National Family Opinion Research (NFO), Inc.  This was the first time that the national publication had devoted virtually an entire issue to sex and relationships.  The AARP study also dispels the myth that seniors are not interested in sexual intimacy.

        In terms of frequency, among those with sexual partners, the researchers found that more than 62 percent of men ages 45-59 and 64 percent of women ages 45-54 reported that they engage in sexual intercourse once a week or more, as do more than a quarter of those 75 and older (26 percent for men and 24 percent of women).

       More than seven-in-10 of those with partners (72 percent for men and 75 percent for women) stated that they engaged in intercourse at least once a month.

       Additionally, the AARP study found that older persons are finding their partners more physically attractive over time.  Going against the popular “youth-oriented” culture, the number of people who view their partners as romantic and-or physically attractive does not decline with age.  It may actually increase, the study said. Sixty percent of men aged 45-59 gave their partners the highest possible ratings for physical attractiveness.

       With the graying of America’s population, it is now time to bring senior sexuality out of the closet.  We must accept the fact that sexuality continues throughout the human life-span, and encompasses more than just intimate sexual intercourse.  It also includes cuddling, a tender kiss, a light touch on the shoulder, or holding hands.

      A well-known song, “As Time Goes By,” reminds us sexuality is to be experienced by both young and old. “You must remember this, a kiss is just a kiss, a sigh is just a sigh, the fundamental things apply, as time goes by.”

      For a bibliography list on sexuality and aging go to www.siecus.org.

      Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues.   This article was published in the August 21, 2001 issue of the Pawtucket Times.

Senior must beware of heat, humidity

Published in Pawtucket Times on August 13, 2001

Temperatures reaching the mid-90s, combined with high humidity represent a serious health hazard for seniors.  But many seniors are heeding the advice of experts, gleaned from radio and newspaper articles, about how to cope with the scorching summer heat.

As to the heat wave, “we can’t control it but we certainly can deal with it,” says Pawtucket resident Paul Audette, who notes he has learned how to cope by listening to health experts.

The 71-year old senior staff manager at Pawtucket-based Providence Metalizing has consciously slowed down his activities, is drinking plenty of liquids and is staying out of the hot sun.

During the heat wave, Audette relaxed in the afternoon and goes out later in the evening when it becomes cooler.

Rep. Mabel Anderson, (District 77) also heeds the advice of health experts on radio programs and is coping well with the intense summer heat.

“I stay quiet, avoid going outside to run errands,” says the Pawtucket resident, noting that she drinks plenty of water to keep from becoming dehydrated. 

Anderson’s son, Jon, has also installed an air conditioner in her bedroom.  With three overhead fans in other rooms, Anderson keeps cool and comfortable.

Seniors, small children and the mentally ill are the most susceptible to health problems from the searing summer heat wavers, according to Dr. Patricia Nolan, director of Rhode Island’s Department of Health.

According the Nolan, the early systems of heat-related illnesses include muscle cramps in arms, hands, abdomen and legs.  Muscle cramps are a result of dehydration and salt loss, this being one of the primary problems associated with heat stress.

Additionally, Nolan says that fainting in the heat is another early symptom.

A person who has fainted due to heat should be taken to a cool place and refreshed using a wet cool cloth.  Nolan recommends, “You want to sponge people down and fan them to reduce their body heat,” she says.

Heat exhaustion or heat stroke is a more serious problem related to dehydration caused from high temperatures, Nolan stated.  Feelings of complete exhaustion, confusion, nausea or vomiting are real danger signs, she said.  Treatment involves bringing down the victim’s body temperature by adding fluids through intravenous methods.

To successfully beat the heat, Nola recommends that seniors cut back on outside physical activity and drink plenty of water.

While water is the best fluid to drink on a hot day fruit juice can be considered a viable substitute.  “Cooling off with a cold beer is not the best plan, “Nolan says, because alcohol, coffee tea and soda, loaded with caffeine, can dehydrate you.

Nolan warns that with temperatures in the mid-90s, staying indoors in an uncooled house or apartment is not the best thing for seniors to do.

“Go to an air-conditioned shopping mall, see a movie, visit a restaurant, or get yourself into an air-conditioned space.” She recommends. “If you can do this for an hour on a really hot day you can protect yourself from serious heat-related problems”.

Sometimes seniors get into trouble during days with high temperatures because they just don’t realize the danger, Nolan notes.

During these days it becomes important to monitor your elderly parent or older friends, she says, “Call on them every day to make sure they are coping with the heat.  Take them out to a cool place, like shopping mall, a library or a restaurant to let them cool off.”

Congressional report spotlights nursing home abuse

Published in The Times dated August 6, 2001

Congressional investigators have recently released a scathing report charging that within the last two years more than 30 percent of the nation’s nursing homes – about 5,285 facilities – were cited by state inspectors for at least one abuse violation that had the potential to cause harm.

These facilities were cited for almost 9,000 violations during the two-year congressional study, the report said.

Citing information gleaned from a sampling of state inspection reports or formal complaints, the 15-page report released last week at a hearing called by Henry Waxman (D-Calif), Minority Chairman of the House Committee of Government Reform, found that in more than 1,600 nursing facilities, approximately one out of every 10, the abuse violations were serious enough to cause significant harm to residents or to place them in immediate jeopardy of death or serious injury.

Abused residents were punched, choked or kicked by staff members or other residents, the report said, stating that the attacks frequently caused serious injuries such as fractured bones and lacerations.  In other instances, residents were being groped or sexually molested.

Although the report, “Abuse of Residents is a Major Problem in U.S. Nursing Homes,” prepared by Minority Staff of the Committee’s Special Investigation Division, found that the percentage of nursing facilities with abuse violations is increasing, it noted that the reasons for this increase are unclear.

In his opening remarks, Waxman stated that it had been unwise for Congress to repeal the Boren Amendment in 1997, a federal law which mandated that states provide nursing facilities with adequate funding to operate.  Because of this, he said, Medicaid funding for nursing facility care has not kept pace with the rising costs of providing care.

Waxman’s legislative prescription for attacking the growing abuse in the nation’s nursing facilities is to introduce a legislative proposal that would reestablish the abolished Boren Amendment, mandating minimum nurse staffing requirements, imposing tougher regulatory sanctions on poorly performing facilities, and instituting criminal background checks for nursing facility employees, or increasing internet disclosures on nursing facility care.

What’s playing out in Rhode Island?

According to Wayne Farrington, Chief of Facilities Regulation at the state’s Department of Health, the reporting of Rhode Island abuse complaints has risen by 10 percent.  The statewide increase in reports of abuse, neglect and mistreatment probably mirrors the tragic national problem, he tells All About Seniors, but is smaller because the Rhode Island 1987 statute has made it a misdemeanor for health care professionals or public safety officials not to report suspected abuse, neglect, mistreatment.  The size of the national increase is partially due to abuse reporting being a new requirement in some states.  Farrington added. 

Farrington states that the biggest factor that increases the number of reported calls of abuse, neglect and mistreatment is the severe statewide staffing shortage in Rhode Island’s nursing facilities.

“Overworked staff may become short tempered and this can result in abuse.  Not enough staff in the facility may also result in resident’s needs not being met,” he added.

Administrator Hugh Hall, of Cherry Hill Manor, also feels that the state’s critical staffing crisis contributes to the possibility of increased abuse and that crisis also affects the quality of care provided in the state’s 104 nursing facilities.

“Today’s nursing facility employees are underpaid, overworked creating an environment in which even the best employee may falter,” Hall said.

The administrator urges the General Assembly to increase Medicaid payments to more adequately cover the nursing facility’s actual cost of care, allowing for greater increases in direct care provider salaries.

“While last year’s average cost of care in a Rhode Island facility was $140 per day the state’s Medicaid program only reimbursed facilities $116 for the care provided, creating a serious shortage of funds in many facilities, Hall added.

“There are not enough certified nursing assistants in the system to deliver the care,” Hall said noting that opportunities must be created and a fair wage paid to attract people into this profession.

Meanwhile, Hall believes that the overwhelming majority of nursing facilities in Rhode Island provide quality care.  These facilities do criminal background checks and provide staff training.  They educate their staff about the facility’s expectation on quality patient care, he said.

Hall says facilities that have on going problems with abuse should be prosecuted to “the fullest extent of the law.”

Although Roberta Hawkins, the state’s Long-Term Care Ombudsman and Executive Director of the Alliance for Better Long-Term Care sides with Farrington and Hall about the critical need to directly confront the adverse impact of the staffing shortage in facilities, “it’s not to excuse to provide bad care,” she says.  “If facilities can’t care for residents then they should not admit them.”

A mandated continuing education program for both professional nurses and certified nursing assistants can be an effective strategy for reducing the incidence of abuse while enabling the better trained worker to care for more medically complex residents.

Additionally, Hawkins and long-term care providers are pushing for more state and federal Medicaid dollars to be allocated to provide a living wage for direct care workers.

Although lawmakers this year gave a small increase, “it’s not what was needed but it’s a start,” she acknowledges.

A divided Congress and a conservative Bush White House may well keep Waxman’s legislative proposal that addresses the problem of rising abuse in the nation’s more than 17,000 nursing facilities from every being enabled.

So, change must begin in the Ocean State.

When the Rhode Island General Assembly comes back into session next year, it becomes critical that the serious direct care staffing shortage in Rhode Island’s nursing facilities become a top legislative priority.

As the Republican and Democratic Gubernatorial candidates gear up their political campaigns and dream of becoming the state’s top elected policy official, they might well consider taking up the just cause of improving the care provided in the state’s nursing facilities.

Lawmakers can gubernatorial candidates can ill afford to ignore this key policy issue, one that puts the state’s 10,000 frail nursing facility residents in continued jeopardy of abuse, neglect or mistreatment.

On a political note, hundred of thousands of families and friends of these residents, who are voters, are watching.