Sexuality in the nursing home patient

Sexual behavior is an integral part of human existence. The changes of aging affect all stages of sexual response in both men and women, but the capacity to enjoy sex is not altered with age. Surveys demonstrate that while sexual activity declines with age, a significant proportion of elderly persons, including those in nursing homes, remain sexually active. Barriers to sexual expression for residents of long-term care facilities include lack of privacy, chronic illness, lack of a willing partner, loss of interest, attitudes of physicians and staff, feelings of unattractiveness and an insufficient understanding of sexuality. Physicians can help remove barriers to sexual expression for elderly nursing home residents by improving privacy, educating staff, allowing conjugal or home visits, assessing decision-making capacity in cognitively impaired elderly persons, encouraging several forms of sexual expression, providing information and counseling about sexuality to interested patients, and evaluating patients' complaints about sexual functioning.