We all have a basic underlying need for physical intimac, so even if sexual desire has declined as age advances, partners can still be intimate by being physically close, like holding hands. - MCT
The issue of physical intimacy in the elderly is very often neglected in mainstream medicine.
When I think about the 2003 movie Something’s Gotta Give, one of the scenes I remember best is the one where 63-year-old playboy Harry Sanborn (played by Jack Nicholson) cuts up 56-year-old playwright Erica Barry’s (Daine Keaton) shirt during foreplay.
This is partly because I found the act rather odd in terms of arousal (although Barry certainly seemed to find it exciting), but also partly because it was the first time I could personally recall seeing an overtly sexual scene between two senior citizens on screen.
According to the Netherlands’ Saxion University of Applied Sciences School of Health professor of elderly and palliative care Dr Hilde M. de Vocht, the most common misconception about older people and sex is that they are completely asexual.
The psychologist says research has shown that both men and women can be sexually active and responsive well into their 80s and 90s. “Everybody should decide for him- or herself what they do or don’t want to do, but biologically, it is perfectly possible to be sexually active into very old age,” she says.
Prof de Vocht was in Kuala Lumpur earlier this year for the 7th Malaysian Conference on Healthy Ageing, where she conducted a pre-conference workshop and gave a plenary talk on sexual health and ageing.
It can't be denied that the natural decline in the production of sex hormones, which occurs with advancing age, does affect the body’s libido and physical functioning during sexual arousal. For example, men find it harder to produce and maintain an erection, while women also find it harder to become aroused and have difficulties with vaginal lubrication.
Often, the sexual drive decreases, although Prof de Vocht notes that that doesn't mean it goes right down to zero, especially for those who have been sexually active since their youth. “Very often, there are interventions possible to remedy these physiological problems. There are many treatment options for erectile dysfunction, and there are many treatment options for vaginal dryness,” she says.
Cancer And Sex
Prof de Vocht, who did her Doctor of Philosophy (PhD) degree on Sexuality and Intimacy in Cancer and Palliative Care in the Netherlands, notes that sexual health remains an important, if often neglected, area to address in such patients and their partners.
“First of all, it is very important that before doctors start treatment, they have to give proper education about the side effects of the treatment. I think people have a right to know before they consent to having a certain medical therapy, what the side effects are. And there’s nearly always a massive side effect on sexual function.”
She shares that some prostate cancer patients have even refused treatment because it often results in erectile dysfunction. She says: “Often, when one of the partners becomes seriously ill, there will be a different trajectory. The patient will be focused on survival and undergoing the treatment, while the partner is healthy and probably sexually interested.
“So, their paths are diverging... the key thing is to find a way to bring those paths back together in finding a form of intimacy, be it sexually or otherwise. And many couples have seen that if they do not succeed in finding what I sometimes call a ‘new normal’ – a new way of being intimate together, their paths will only diverge further and very often that results in a break-up.”
She adds that to put it bluntly, if there's no intimacy between a couple, then there's no difference between their relationship and friendship.
Fulfilling A Need
Of course, intimacy is not just about sex. Says Prof de Vocht: “Even if the treatments (for sexual problems) don’t work, or if people choose to stop being sexually active, then it still doesn’t have to be a big problem, because I think the basic underlying need people have is the need for physical intimacy.”
She adds that this need can be fulfilled in many ways, aside from sex. This includes hugging, kissing, cuddling and falling asleep side by side, among others. In fact, she notes that some nursing homes in the Netherlands allow animals like rabbits, cats or dogs, for lonely residents to cuddle and pet.
“It may sound very strange, but even that can help to fulfil the need for physical intimacy. It’s feeling a warm, living, responding being, and that can help,” she says.