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older canadians are having more sex — and it's really good. so why does it bother us so much?

growing older doesn't mean that we stop being interested in sex, yet discussions around intimacy in later years continues to be met with stigma by society, but also among health-care providers.

older canadians are having more sex — and it's really good. so why does it bother us so much?
many physicians have closed or negative attitudes, are uncomfortable or ignorant when discussing safe sex with their senior patients. getty

sex at an older age, as george burns once said, is like trying to shoot pool with a rope. it may sometimes be challenging, but the spirit — and flesh — of many seniors seems awfully willing. and while updated numbers for canada are hard to come by, according to a 2017 poll by the sex information & education council of canada (sieccan), older adults view sex as a key component of their happiness and well-being, and many are partaking well into their 70s and 80s.

a 2001 canadian sexual health survey reported more than 92 per cent of respondents said sex is an important part of life. in a 2002 edition of its bulletin , the national advisory council on aging, titled “sex over sixty,”cited a survey that reported a large majority of canadians between 65 and 74 described themselves as sexually active.

and they appear to be having better sex than ever, says laura tamblyn watts, founder, president and ceo, of seniors’ advocacy organization canage . “satisfaction rates have gone up, they’re having sex more often, it’s better quality, there’s more attention paid, they’re having different kinds of sex. it’s not just the rush between when one kid goes to bed and the other to soccer practice. there’s more time and opportunity.”

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seniors also don’t have to worry about the risk of pregnancy, and they know their bodies better — what they like and don’t like — and are often not shy about communicating it. many are willing to try experimenting with role playing, lubricants and sex toys.
that’s not to say it’s all contented sighs and afterglow. testosterone declines in older men, leading to difficulty maintaining an erection, while estrogen drops in older women, leading to dryness and painful sex. in some cases, underlying health issues, such as arthritis and heart issues, can also get in the way.

the need for closeness doesn’t go away as we get older

it’s no secret our population is aging , with the oldest baby boomers around 75 who came of age around the sexual revolution, and are more open to conversations related to their sex lives. however, many older people today came of age in a relatively conservative era, when sex for pleasure was a sin, so they’re not necessarily comfortable talking about it, let alone pursuing it.

but there are many benefits to being sexually active, including increased self-esteem, a greater sense of well-being, a stronger immune system, closer intimacy and connection, reduced anxiety, and improved sleep.

as author erica jong — who has written about older women with healthy appetites for sex — puts it: “sex doesn’t disappear, it just changes form.” meaning it doesn’t necessarily involve penile-vaginal intercourse. it can be as simple as holding hands, kissing, hugging and caressing.

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“that’s not just for older people,” says natalie rosen, associate professor, department of psychology and neuroscience, dalhousie university, who generally counsels couples transitioning to parenthood but is also a practising sex therapist and teaches human sexuality. “those core needs for closeness and human contact that everybody has doesn’t go away as people become older. it might not go further [than kissing or holding hands] but that doesn’t mean it isn’t intimate and sexual behaviour. it might look more like foreplay — more turn taking, more breaks, different positions. those who are open to that see it as normal changes that happen with time, and are the ones who continue to be satisfied and happy with where their sex lives are.”
and drugs like viagra can increase the opportunities (and stamina). but again, not without issues. “erectile drugs are effective, but it’s not like you take a pill and an erection happens and stays forever,” says rosen. “there still has to be sexual arousal and stimulation. there’s also evidence that a good chunk of men get one prescription and never refill it. so it’s about managing expectations, meeting each other’s needs and what that looks like.”

sex in retirement homes and long-term care

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older people who live in retirement homes and other seniors’ facilities face another set of challenges — but also opportunities.
“[they] can still be interested in having sex but issues of privacy, consent, societal stigma — where we don’t want to think or talk about older adults still having sex — can lead to a culture of don’t ask, don’t tell,” says rosen. “consequences [of that may be] they’re not provided with the education or tools to have that safe sex.”

she says if no one’s talking about it, including the resident physicians, there’s no testing for sexually transmitted infection (sti) or discussions around safe sex. according to health canada, since the early 2000s, sti rates for those 60 and older have increased significantly , with a five per cent increase in syphilis, an 87 per cent rise in gonorrhea, and a whopping 142 increase in chlamydia. most older adults are not using condoms — “because they may have been married and in monogamous relationships” says watts — and many of these conditions have no symptoms.

“we really have to teach sexual health to 70-, 80- and 90-year-olds,” she says.

why we are so reluctant to talk about older people having sex?

many physicians have closed or negative attitudes, are uncomfortable or ignorant when discussing safe sex with their senior patients, so they don’t often think of testing for infections. family members, too, may feel awkward bringing up the sex lives of their elders. and retirement homes appear to be lagging in educating their residents.

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“staff should have awareness and manage it in a sensitive way,” says rosen. “sexual behaviour can be seen by some people as problem behaviours to manage, which is not a very sex-positive way to be thinking about it. i also think there’s some responsibility on the physician, since they’re ideally suited to initiate those conversations.”
doctors can also be in a better position to assess for cognitive capacity for consent, she says. “if some [retirement home] residents are developing relationships, the physician could be well placed to help navigate privacy, and to support safe and healthy sexual relationships.”
the prevalence of dementia in nursing homes can lead to people being vulnerable to sexual assault. some homes deal with that by creating barriers which prevent the possibility of consensual intimate interaction. but some care home staff say they know their residents well enough to know when they do or don’t want to be touched, and most, if not all facilities have policies in place to protect their residents. also, some advance directives can include sections on whether or not older people want to continue having sex after they’re unable to verbally consent.

with the rapidly aging population, this conversation needs to be had, and it needs to be normalized. in the meantime, canada’s public health agency has published a resource called questions & answers, prevention of sexually transmitted and blood borne infections among older adults .

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boomers are more comfortable ‘coming out’ than ever before

another benefit to living in a retirement community, besides opportunities for close relationships, sexual or otherwise, is that some residents feel that now that they’re older, maybe divorced or widowed, they can be free of stigma and are coming out as gay — some even after having been in heterosexual marriage all their lives.
“even if they were married their whole life to a person of the opposite sex, that doesn’t mean that they don’t have different sexual interests or attractions that they’re now more comfortable with or want to explore,” says rosen.
“baby boomers in particular are feeling more comfortable coming out than ever before,” since their generation has more awareness, generally, and fewer assumptions about people.
“my main advice is to be flexible, adapt what you used to do to some of the changes that you’re experiencing, [and] communicate with your partner,” says rosen. “long-term care homes need to reduce stigma, and not make assumptions that sexual activity isn’t happening. be open and forthright with residents [in a way] that supports their agency and equips them with the education and support they need to be safe.”

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robin roberts is a vancouver-based writer.
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