Having Sex Boosts Old People’s Health

—We Should Be Talking About It

By and

Humans are sexual beings. This urge does not stop when the clock strikes 60. Or even 90.

Young adults may deny older relatives are having sex, but sexual activity is a strong indicator of healthy aging and vitality. In fact, sexual activity is roughly equal to climbing two flights of stairs.

Sex education and research use a medical model of sexual health focusing mainly on pregnancy, sexually transmitted infections (STIs), and sexual dysfunctions. However, sexuality is complex. Beyond genitals and Kama Sutra-like positions, it considers sexual and gender identity; sensuality; sexual response; intimacy; and positive and negative ways we use our sexuality.

Our research has explored sexuality among older adults experiencing healthy aging and also aging with health challenges. We found that older adults who routinely talk with health care providers about sexual matters are more likely to be sexually active, despite sexual dysfunctions or other health issues. These conversations become more important considering high HIV/AIDS and STI rates, even among older adults in the U.S.

Sexuality is complex

As we age, the complex interplay among biological, psychological, cognitive, socioeconomic, religious and even societal factors, contribute to changes in our roles and responsibilities. For example, changes in physical or cognitive health over time can create differences in analytical thinking, mobility, and health care needs. We also experience changes in work, social and family roles and responsibilities over time. Examples include transitions from working to retirement, parenting to empty-nesting, child-rearing to caring for aging parents or partners.

These changes may alter our sexual desires, expression and the frequency in which we engage in sexual activities with partners. For example, sexual functioning and activity may decrease over time, but having open communication with a partner who is responsive to our needs can increase our feelings of intimacy and desire, and in turn stimulate sexual activity.

Evolving social support and activities may change opportunities for sex and intimacy. Partners may disappear through death or moving away, or appear, such as when meeting new people after moving to an aging community. Over one-third of adults over age 65 use social media or internet technologies. These tools may expand sexual interest or activities by increasing access to sexual aids and partners.

Sex after 60

There are myths, misconceptions and stigma associated with aging and sexuality that hinder older adults’ ability to openly communicate with family, friends and health care professionals. This misinformation limits their access to sexual education, health care, and ultimately, their sexual rights.

The first myth is that older adults are not as sexually attractive or desirable as their younger counterparts. While an 80-year-old may not be as appealing to an 18-year-old, he or she may be very desirable to peers. More importantly, he or she may feel more sexually desirable and confident than their younger self.

A second myth is that older adults lack interest in and desire for sexual activity—and that they are somehow asexual. Research from ongoing national surveys support the ideas that sexual interest, desires and behaviors can decrease over the life course. For example, among women ages 57 years and older, over 80 percent of participants expressed interest in having sex, but less than two-thirds of women surveyed perceived sex as “important,” and fewer than half reported having sex in the previous year. However, the reality is that these trends are not universal among older adults. Results from another recent survey found that 39 percent of men and 17 percent of women ages 75 to 85 years are sexually active.

Another myth is that older adults are so medically fragile that sexual activity is dangerous. This is simply not true in many cases. Recent studies have shown that healthy older adults are more likely to have sex. Even when chronic illnesses are present, sexual abstinence is not a foregone conclusion. For example, a 2012 American Heart Association statement contains evidence-based recommendations about sexual activity among patients with specific cardiovascular conditions. The recommendations generally advise assessing risks with a doctor and disease management, rather than abstention.

There are well-documented relationships between common medical conditions such as heart disease or diabetes and treatment-related effects on sexual functioning. Yet, older adults and their health care providers are not discussing sexual concerns during routine care. Missed opportunities during visits deprive older adults of access to newer treatments and other best practices in sexual medicine, which can impact their mental and physical health.

A bigger problem may be ageist attitudes among providers and internalized ageism in their patients that may interfere with sex education and application of newer standards. The result is that many believe older adults are uninterested in, or lack desire for, sexual activity and cannot engage in these activities.

Love has a lot to do with it

There is more to sexuality than physical acts. While much of the existing research focuses on sexual activity and intercourse as predictors or outcomes, most older adults also desire companionship, intimacy and closeness. Non-intercourse-focused activities, such as hand-holding, cuddling and massage, have not been studied as much as intercourse. Yet, there is reason to believe that they can enhance intimacy. Research about physical and mental health outcomes resulting from older adult sexual activity reveals additional benefits, including reduced cognitive decline, loneliness and depression, and improved reported health status, physical functioning, and other aspects of quality of life.

Recent studies also reveal that sexually active older adults are more likely to communicate needs and concerns with health care providers and have them addressed. Providing high-quality sexual health care requires providers to take comprehensive sexual health histories from older patients and engage in direct, positive communication concerning gender and sexual identity, and sexual knowledge, beliefs and practices.

Discussions should promote understanding about sexual risk behaviors for STIs and effects of physical and cognitive or psychological aging on sexual health and sexuality. To maintain or improve older adults’ sexual health and well-being, health care providers should provide safe and welcoming environments for patient-provider collaboration, resources and interdisciplinary referrals to clinical social workers, sex therapists, physical therapists and other allied health specialties.

Complete Article HERE!

LGBT seniors grapple with end-of-life issues

by Matthew S. Bajko

While enjoying her seventh decade on the planet, Donna Personna knows her remaining days are numbered. Yet the prospect of her demise doesn’t scare her.

“The end question. ‘The end.’ It’s not a touchy subject for me. I’m irreverent,” said Personna, a transgender woman who grew up in San Jose and now lives in San Francisco. “I have been on the planet for 72 years. I learned long ago this was going to come.”

Personna, a beloved drag performer, playwright, and hairdresser, credits her Mexican heritage with teaching her that death is a part of life. She pointed to the annual Dia de los Muertos holiday — the Day of the Dead in early November — as one example of how, from an early age, she was taught to embrace one’s mortality rather than fear it.

“I am not worried about it. It doesn’t scare me,” said Personna, who graduated with honors from San Jose State University and, for years, owned her own hair salon in Cupertino, which she sold a while back but continues to cut hair at once a month for longtime clients.

Born into a large Baptist family with 16 siblings, Personna remains close with several of her older brothers and their families in the Bay Area. She is confident she can rely on them in the case of emergencies or if her health deteriorates.

“Some of my nieces said, ‘You can live with us,'” said Personna, who has designated one of them the beneficiary of her estate.

Her Plan B, however, is to move into a pueblo outside Guadalupe, Mexico where her Social Security check and personal savings will be worth more.

“I want to spend the rest of my days in Mexico. I don’t want to die in San Francisco,” said Personna. “I am longing to go there.”

Confronting the end of one’s life isn’t easy for the majority of seniors, whether LGBT or straight. Most have not declared an executor for their estate, let alone discussed with their physician what sort of care they want in their dying days.

“It is rooted in the death phobia that North American culture has,” said Brian de Vries, a gay man and professor emeritus of gerontology at San Francisco State University who is a leading expert on end-of-life issues among LGBT seniors.

There are an estimated 2.7 million Americans who are LGBT and 50 years of age or older. Of that age group, 1.1 million are 65 and older. By 2060 LGBT elders in the U.S. are expected to number more than 5 million.

This generation of LGBT seniors differs from its heterosexual counterpart in significant ways, according to aging experts. Most of the LGBT seniors experienced discrimination not only in their day-to-day lives but also in medical settings due to their sexual orientation or gender identity.

LGBT seniors are oftentimes no longer in touch with their birth families, having been ostracized after they came out of the closet. And many don’t have a partner, spouse, or children of their own to rely on as they age.

“The issues around aging alone are particularly meaningful in LGBT seniors,” said Lisa Krinsky, 55, a lesbian who is the director of the LGBT Aging Project at the Fenway Institute in Boston.

And in the case of many older gay men, they lost their families of choice, whether it was their friends, partners, or spouses, to the AIDS epidemic. Thus, they are more likely to be aging alone. And if they are living with HIV, they are largely unprepared for their retirement years having believed they would have died by now.

Dearth of research
For LGBT seniors, living alone “sets them up to more likely need institutional care as one gets older,” said Daniel Stewart, a doctoral student and adjunct professor at Saint Louis University in Missouri.

Stewart and his colleague, Brandy Fox, a Ph.D. student at the university’s Center for Health Care Ethics, presented their research on LGBT older adults’ end-of-life perceptions and preparations at the Gerontological Society of America’s annual conference, held last month in Boston.

“There is not a lot of research on LGBT end of life,” noted Stewart.

Talking about the end of one’s life can be exceedingly difficult for LGBT seniors, according to aging experts, because of their lack of trust in their health care providers or not having close familial or social connections, leaving them without a family member or friend they can turn to and discuss how they want to be cared for as they age.

“We know gay and lesbian seniors delay getting care,” said Kysa M. Christie, Ph.D., a clinical psychologist at the Veterans Affairs Boston Healthcare System during a panel at the aging conference focused on palliative and end-of-life care for LGBT older adults.

The reasons can vary, said Christie, from internalized homophobia and heterocentrism to stress-related stigma and poverty. It is estimated that one in five LGBT seniors, she said, “have no one to call in a crisis. Compare that to one in 50 for heterosexual seniors, so that is a stark difference.”

Fox and Stewart interviewed 17 LGBT seniors living in the Midwest about end-of-life issues. The cohort expressed concerns about being a burden as they aged and largely had unfavorable views of health care settings, particularly religious affiliated hospitals.
As one 78-year-old woman told the researchers, “Me and the medical profession do not get along,” recalled Fox.

De Vries and his colleagues in the field of LGBT aging call the lack of discussions about one’s palliative care needs, from who will be one’s power of attorney to what a person’s advance directives are for their medical care, “the missing conversations.” It is a subject that seniors must repeatedly address as their circumstances and choices may change as they age.

“I like that it is plural, as once you have the conversation people think you are done with it,” said de Vries. “It is hard enough to have the conversation. And once you have it, you want to wipe your hands dry and move on. As if that is it; it is one of many conversations people need to have, I think.”

For several years now de Vries has been involved in research in Canada looking at end-of-life issues among LGBT seniors. In one paper de Vries co-wrote, and is under review at the International Journal of Aging and Human Development for inclusion in a special issue on LGBT aging, he and his colleagues note that evading end-of-life discussions “keeps death ‘in the closet’ — along with one’s hopes, fears, and wishes about their end of life.”

The issue struck close to home for de Vries six years ago when his husband, John Blando, Ph.D., who is also a professor emeritus at SF State having worked there as an instructor/adviser in the Department of Counseling, was diagnosed with Parkinson’s disease. The men, both 62 and together 33 years, began to seriously discuss end-of-life issues, such as how to care for each other, as they drew up their wills and estates. When they moved four years ago from San Francisco to Palm Springs and had to revise their wills, they also completed their advance health care directives and durable powers of attorney.

“These naturally involve deeper discussions about end of life — at least that was our experience,” said de Vries. “Of course, elements of end-of-life discussions have dotted our other conversations as we talk about our plans and hopes for the future. I will admit to some discomfort in some of these conversations — about raising issues that we both fear, about releasing strong emotions — but they ultimately rest on expressions of love and opportunities to share.”

‘Death cafes’

Aging expert Brian de Vries, right, with his husband, John Blando, Ph.D.

Since the couple retired to Palm Springs, de Vries has continued to work on end-of-life issues and helped launch a group called PALS, short for Planning Ahead for LGBT Seniors. It presents seminars where people can discuss a range of palliative care issues, from entering hospice care to planning one’s funeral.

“We have a funeral home director come in who is gay and talks about his experiences and the issues and the complications he has seen and how they could be mitigated if people only planned ahead,” said de Vries.

He also borrowed a concept from Britain known as a “death cafe,” where people meet socially to talk about death and dying issues. The gatherings are held at least once a month in Palm Springs and attract upward of 20 people or more.

“What is so neat is it is an in-your-face approach to it. It is not a ‘passing away cafe’ or something subtler. It is a death cafe,” said de Vries. “The idea is it just kicks the door open and brings it out of the closet and brings it into a public space and invites people who may not know each other to a safe space to have these conversations.”

For those LGBT people who have thought about how to plan for their end-of-life care, they tend to focus solely on matters related to their death or dying and not the months or years leading up to their final days. As an example, de Vries said when he once asked a focus group of gay men if they had a will or written out their funeral plans, most had. Hardly any of them, however, had determined who in their life would take them to the hospital or pick them up when, and if, they were discharged.

“It kind of provides an entry into this. It is a bit innocuous to ask someone, ‘I need a ride back and someone to sit with me for an hour, would you do that?’ People feel honored to have been asked and that someone cared enough about me to think I could help them with this,” said de Vries.

Asking for help isn’t always easy for LGBT seniors, noted the Fenway Institute’s Krinsky, even when they have family or friends who can assist them. She recalled talking once to a group of 20 older lesbians and asking them if they would be willing to go to the pharmacy for a friend.

“Eighteen said they would go for someone,” said Krinsky.

But when she flipped the question and asked the women if they would request help for themselves in getting their medications from the pharmacy, “only eight hands went up.”

Krinsky refers to such a model of care as “horizontal caregiving,” where a circle of friends, neighbors, and/or co-workers rely on each other to look after one another.

“We see tight families of choice taking care of each other as best as they can,” she said, “as people are concerned about how will I care for myself as I age.”

Such a structure, she said, upends the heteronormative approach of relying on one’s biological family to provide caregiving. It is expected that a married straight couple’s children and grandchildren will look after them in their senior years and that responsibility is passed on with each new generation.

“Right now, we a have a vertical model of multi-generational caregiving,” Krinsky explained.

Challenges
Even though Personna lives in an LGBT-affirming city like San Francisco and has her family’s support, she is cognizant of the fact that there are still challenges that LGBT seniors must confront.

“Because of my orientation it is totally different than a heterosexual family and their end-of-life situations. So many things are already in place for them,’ she said. “By law you get things and your family connection is built in. My community, we have to build that and do the work. People my age usually don’t have what the heterosexual person has, like built in grandkids to come over and take you to lunch.”

Five years ago Personna moved from Cupertino into the city to help care for her friend, Bill Bowers, 71, a member of the famed gender-bending group the Cockettes whose outrageously designed jackets became a must-have for rock stars such as the members of the Rolling Stones and Led Zeppelin.

Bowers, a gay man who is HIV-positive, had been living alone at the Derek Silva Community when he had a stroke that left him unconscious for two days in his studio apartment. After that episode, he moved into a two-bedroom unit so that he would have a roommate who could look after him. After he lost his first roommate to cancer, Bowers asked Personna to move in.

“I can’t live alone,” said Bowers. “I asked Donna because she was traveling back and forth from the city to Cupertino on weekends to move in. She is here to be my caregiver.”

Personna not only ensures Bowers makes it to his various medical appointments and takes his daily regimen of medications but also provides companionship. They also share many of the same friends and can reminisce about their younger days in the city.

Bowers has designated an executor for his estate and thought about how he would prefer to be cared for at the end of his life. For example, he doesn’t want to be put on life support should it come to that.

He expects to live out his days in San Francisco, though Bowers said if he could afford it he would spend the rest of his days in Paris or somewhere tropical, like Tahiti or the jungles of South America.

Unafraid of death, Bowers is concerned about how he will die.

“I don’t want to suffer,” he said. “I watched my former roommate go through weeks of suffering. I don’t want to go through that or have someone have to watch me suffer.”

Complete Article HERE!

Gay Grief Is Different

On this 30th anniversary of World AIDS Day, Sue Rakowski explains how LGBTQ mourning is singular.

By Sue Rakowski

Grief, as you might have sadly discovered, is like a river that takes us where it wants us to go. We can’t stop those heartbreaking reality waves of anguish but we can learn to once again drift with purpose. Getting there is rough, because no matter how many well-meaning friends tell you “time heals all wounds,” there are just some losses we get “through” but we never get “over.” No grief is like your grief because no relationship was quite like yours.

Grieving the loss of a loved one is horrific enough, but it is even harder when you’re a member of the LGBTQ community. I know. I’ve felt this disenfranchised grief. Gay grief is marginalized. Many of us, depending on where we live and what kind of network we have, are excluded from experiencing society’s mourning process.

My girlfriend of 14.5 years died five years before same sex marriage was made legal. While I was the health care proxy and caregiver, I’m haunted that I was not able to file a wrongful death suit regarding medical malpractice because I was not an “immediate family” member. I was not invited to the funeral hosted by her family. And compared to many of my gay sisters and brothers, I got off easy.

There are thousands of members of our community who cannot even tell their employers that the love of their life has died for fear of losing their job, and much worse.

We’ve made significant inroads in the past decade. But despite legislation on same-sex marriage, a push for tougher anti-hate crime laws, and the World Health Organization’s declassification of transgender people as ‘mentally ill,’ the prejudice has not gone away.

The current administration has unleashed a culture of hate that is once again stacking the deck against us. They have erased LGBTQ terminology from various government forms. Beautiful families with same-sex parents are scrambling to lock down their rights in the event that rulings are overturned. Many are forced to conceal their true selves for fear of harassment. This dread and anxiety, especially among our trans family members, is making access to proper healthcare a terrifying experience.

Homosexuality is illegal in 73 countries. While not criminal in the U.S., there is a menacing climate present that ranges from wedding cake controversies to harassment and beatings.

If you lose your precious love, you might be denied a proper grieving process. This grief is forceful, commanding and unpredictable. We must grieve the loss of our loved one and the person we became with our love by our side.

If a long-term illness is the ultimate cause of death, will the medical staff be considerate and respectful of your relationship? How will you manage the discussions with the funeral home and cemetery arrangements? Will it be difficult to deal with your dear mate’s family? Are you afraid to tell your boss and co-workers about your relationship? These are questions straight people never have to ask.

Gay grief is often not taken as seriously as the bereavement process is for a hetero relationship. Co-workers, neighbors, and so forth, might not have any gay people in their circle of friends and don’t know what to say. They might not even try to console you. You might be completely ignored.

It’s important to stick close to like-minded people, your LGBTQ family, friends and straight allies. The good kids on the block. If your gay community is small or non-existent, reach out to online resources including the Human Rights Campaign, The Trevor Project and Parents & Friends of Lesbians & Gays (PFLAG) to make connections.

Look for a place to put your pain. Create a memory box with notes, cards, mementoes and souvenirs of your love. Write a letter and say all the things you wished you had time to say. Schedule a grieving session with yourself every day or week until the rushing river begins to subside a bit. Consider joining a grief group, but wait for the loss to really settle in — that could take four to six months.

Finding a gay grief group is, of course, the optimum situation. Talk about your grief with caring people. Reminisce. It helps.

A naming opportunity offers much solace. Find a charity building a walkway or other structure and buy a brick, for example, with your loved one’s name on it. Contribute to a program that places park benches in your town inscribed with your loved one’s name. If this is not an option, plant a flowering shrub or tree to honor your lost love. Watch it flourish and blossom every spring.

Plan holidays and special dates of observance in advance so you won’t be alone or succumb to last minute plans with callous people who don’t, won’t or can’t acknowledge your loss.

Join organizations, get involved. You might be able to help someone who is also grieving this traumatic death of a love.

Above all, be grateful for the time you spent with this cherished partner. Your life was better for having them in your world. It changed you, it shaped you. Take the golden moments with you. Grief is a war, but you are a survivor.

Complete Article HERE!

Why do grieving men find love faster than widows?

Three years after his wife, Rebecca, died of cancer, former footballer Rio Ferdinand is to marry his girlfriend, Kate Wright.

By JAN MOIR

Till death do us part – but what comes after that final, bleak separation? For lucky Rio Ferdinand, it has meant a new bride and a second chance at happiness.

Three years after his wife, Rebecca, died of cancer, the former footballer is to marry his girlfriend, Kate Wright. He proposed to her in front of his children on a rooftop during a holiday in Abu Dhabi. Everyone is apparently thrilled.

“You can’t even remember what it’s like to feel happy. And then, bam, out of the blue, you meet someone and everything changes,” loved-up Rio told his biographer, the journalist Decca Aitkenhead.

In a recent interview with The Sunday Times, he also encouraged her to follow in his footsteps and find love after suffering her own bereavement.

“You need to get out there and meet someone too. Trust me – you’ll see what I mean,” he said.

In 2014, Aitkenhead’s partner, Tony Wilkinson, drowned in Jamaica while trying to rescue their four-year-old son (who survived), leaving her a single mother of two young boys.

When she began contemplating her future without him, she initially worried she’d be romantically taken advantage of as a widow. Now, she wryly concludes that what wise friends told her nearly five years ago has turned out to be true.

While widowers seem to become ten times more alluring to the opposite sex practically overnight, men are not attracted to widows in the same way. Look at Decca: attractive, intelligent, successful – and still single. Love after death certainly seems much easier to achieve for men.

A year after his wife, Gemma, died of cancer, and vowing that she would never be replaced, Sky Sports presenter Simon Thomas has just announced that he is in a relationship with a new girlfriend.

“From the early stages, she had this empathy towards me. She’s been an incredible support for me,” he said, which tends to suggest their relationship has at least partly revolved around him and his grief.

Not all men would be so empathetic if the circumstances were reversed. Some might say 12 months is far too early for a fresh romance, but Thomas has a young son and found the loneliness of widower-hood “brutal”.

Perhaps one reason why men find new love more successfully than women is that they are less likely to have close friends they can talk to, or a social and emotional support network to help them through bereavement. Or perhaps they are just more selfish.

A recent study found two-thirds of widowers were in a new relationship within 25 months, in contrast to less than a fifth of widows. Over the age of 65, the discrepancy is even larger, with ten times as many widowers as widows remarrying.

But don’t worry, ladies, it’s not all doom and gloom. Becoming widowed is associated with a 48 percent increase in risk of mortality.

So, if you are really miserable, you can cheer yourself up with the thought you’re going to die soon anyway. Excuse my jest! For what else is there to do but cackle with dark humour when contemplating this sea of wifely despair?

But why is there such divergence between the sexes in love after death? The fragile male ego, Decca Aitkenhead is warned, cannot reconcile itself to the indignity of a relationship with a woman still in love with someone else.

Most men don’t want to be the second choice or to feel inferior, whereas women find it easier to show a kind of deference to their predecessor, as they know it’s expected of them.

They also know that men are hopeless by themselves, so they make themselves indispensable. They mould and adapt emotionally in ways men find more difficult.

And we cannot overlook the romantic allure of a widower with young children and the torrent of feelings, both maternal and carnal, that can arouse in a woman.

According to the old saying, women mourn, men replace – and hopefully with a younger model, if the devils can possibly get away with it. Instead of forever dwelling on the past, many men aspire to repeat the happiness they knew as husbands, sometimes aided by women who see bereavement as opportunity, not tragedy.

After his wife’s death, Rio Ferdinand talked often about risking a new relationship and revealed that, in the past, he had judged the bereaved harshly.

If a widower began dating within five years of losing his wife, it was Rio’s belief “he never really loved her”. Now he says that if a husband started dating the day after the funeral, he wouldn’t be appalled any more. He would understand. Who is anyone to judge?

Most men and women would want their surviving spouses to be happy above all – to love and be loved in the years to come.

Complete Article HERE!

Living Apart Together: A New Option for Older Adults

Three years ago, William Mamel climbed a ladder in Margaret Sheroff’s apartment and fixed a malfunctioning ceiling fan. “I love that you did this,” Sheroff exclaimed as he clambered back down.

Spontaneously, Mamel drew Sheroff to him and gave her a kiss.

“I kind of surprised her. But she was open to it,” he remembered.

Since then, Mamel, 87, and Sheroff, 74, have become a deeply committed couple. “Most nights, I’ll have dinner with Marg and many nights I stay with her overnight,” Mamel explained.

And yet, despite the romance, these North Carolina seniors live in separate houses and don’t plan to move in together or marry. Demographers call this type of relationship “living apart together” (LAT).

“It’s a new, emerging form of family, especially among older adults, that’s on the rise,” said Laura Funk, an associate professor of sociology at the University of Manitoba in Canada who’s written about living apart together.

Questions abound about these unconventional couplings. What effects will they have on older adults’ health and well-being? Will children from previous marriages accept them? What will happen if one partner becomes seriously ill and needs caregiving?

Researchers are beginning to focus on these concerns, said Susan Brown, chair of the sociology department and co-director of the National Center for Family and Marriage Research at Bowling Green State University in Ohio. “It’s really remarkable that older adults are in the vanguard of family change,” she said.

How many older adults are in LAT relationships? According to a 2005 survey by the National Social Life, Health, and Aging Project, 7 percent of individuals between 57 and 85 years old described themselves as living apart together. (Some experts contend the measure used in this survey was too broad, allowing couples who are dating to be included.)

Last month, at the annual meeting of the Population Association of America in Denver, Huijing Wu, a graduate student in sociology at Bowling Green State University, presented an analysis of nearly 7,700 Wisconsin adults age 50 and older surveyed in 2011. Married couples accounted for 71.5 percent of that group, single people accounted for 20.5 percent, and people who were “partnered but unmarried” accounted for 8 percent.

Of the partnered group, 39 percent were in LAT relationships, according to a more focused definition of this arrangement, compared with 31 percent who were dating (a less committed, shorter-term relationship) and 30 percent who were cohabiting.

Jacquelyn Benson, an assistant professor of human development and family science at the University of Missouri, is among a handful of researchers who’ve asked older adults about their experiences in LAT relationships. “Older adults really see this as a lifestyle choice, not a relationship of convenience,” she said.

Benson’s 2016 study of 25 older adults (from 60 to 88 years old) in LAT relationships found various motivations for these partnerships. Seniors wanted to have “intimate companionship” while maintaining their own homes, social circles, customary activities and finances, she discovered. Those who’d been divorced or in unhappy earlier marriages didn’t want to tie themselves down again and believed a degree of distance was preferable to day-to-day togetherness.

Also, several women who’d cared previously for sick parents or husbands wanted to avoid assuming caregiving responsibilities or the burden of running a household again.

“It’s a been-there-done-that attitude,” Brown explained. “I took care of my husband, I reared my children, and now it’s my time.”

Caregiving is a thorny issue, on multiple fronts. The only known study to look at caregiving in LAT relationships, out of the Netherlands, found that about half of partners planned to provide care, if needed — a sign of ambivalence. But when illness entered the picture, partners offered assistance nonetheless.

“People in LAT relationships forget there’s going to be this emotional entanglement and they won’t just be able to walk away,” Benson said.

Other complications can arise if adult children resent or fail to recognize their older parent’s outside-of-marriage relationship. “In some cases, when a partner wants to step in and have a say, they’ve been pushed out by family members,” Benson noted.

One older woman in her study learned that her partner had been placed in a nursing home by his family only when she couldn’t reach him at home anymore. “They didn’t include her in the conversation at all,” Benson said, “and she was pretty upset about it.”

Only a few studies have evaluated the quality of LAT relationships, which has implications for seniors’ well-being. One found that older adults in these relationships tend to be less happy and receive less support from partners than people who are married. Another, presented at last year’s Population Association of America meeting, found that the quality of LAT relationships isn’t as strong as it is for marriages.

That hasn’t been true for Luci Dannar, 90, who’s been involved with James Pastoret, 94, for almost seven years, after meeting him at a dance at a Columbia, Mo., senior center.

“The first feeling I had for Jim was sorrow because he seemed to be grieving from his wife’s death five months before,” said Dannar, whose husband and oldest daughter both passed away 19 years ago. “I thought maybe I could be helpful to this man because I’d been through those deaths.”

After getting to know Pastoret and realizing she liked him, Dannar laid down her terms. “I told him, I don’t ever want to get married and he said ‘I don’t either,’” she remembered. “And I said if you have a jealous bone in your body, don’t darken my door again. Because I lived 53 years with a jealous husband, and I never want to go through that again.”

Neither wanted to give up their apartments in a retirement community, about 300 steps from each other. “I like my independence,” said Pastoret, who taught in the school of natural resources at the University of Missouri for 33 years. “When I go home at night after supper with Lucy, I’m very happy to be by myself.”

“He comes over at 5 every evening and leaves here about 9, and then I have two hours by myself — my private time,” Dannar said. “We really like our space, our time alone, and we don’t need to be together 24 hours a day.”

Unlike other older LAT couples, they’ve talked about the future and toured assisted living centers together. “Someday, if he needs me to help him or I need him to help me, we will probably rent an apartment together, with our own bedrooms, and hire extra help,” Dannar said. “Our plan is to take care of each other until one of us is gone or we go into a nursing home.”

William Mamel is already making good on a similar promise to Margaret Sheroff, who had a mass removed from her gall bladder late last year and recently was hospitalized with complications from chemotherapy.

“With her in the hospital, I spend most of my days there,” said Mamel, who was a good friend of Sheroff’s with his wife of 37 years, Betty Ann, who passed away 2½ years ago. “Being caregivers for each other isn’t even a question.”

Their situation is complicated by Sheroff’s guardianship for her husband, John, who has advanced dementia and resides in a nursing home. “Marriage isn’t in the picture for us, but that doesn’t matter,” Sheroff said. “We’re taking one day at a time and enjoying being together.”

“Just to be able to have someone that you can wake up with in the morning and talk to, someone to have coffee with and see the smile on their face, is such a blessing,” she continued. “At this time of life, it’s really, really important to have someone in your life who’s there for you.”

Complete Article ↪HERE↩!

Sex Doesn’t Stop with Dementia

Study authors say clinicians shouldn’t forget that patients, partners still want it

by Judy George

Most people with dementia who lived at home and had a partner were sexually active, a national study of older adults found.

Of partnered people, 59% of men and 51% of women who screened positive for dementia were sexually active, including 41% who were 80 to 91 years old, reported Stacy Tessler Lindau, MD, of the University of Chicago, and co-authors in the Journal of the American Geriatrics Society.

This is the first study to establish nationally representative evidence about sexuality and cognitive function of older adults at home, Lindau said.

“Sexuality is an important aspect of life in aging, including for people with dementia,” she told MedPage Today. “We found that people with dementia, mild cognitive impairment, and no impairment share positive attitudes about sex and most said they were having sex less often than they would like.”

Untreated sexual dysfunction stops older people from deriving the full benefit of sex, Lindau added: “Our study shows that people with dementia, especially women, were not talking with their doctors about these problems.”

In this study, Lindau and colleagues analyzed data from 3,196 adults age 62 to 91 from the National Social Life, Health, and Aging Project, a longitudinal study conducted by personal interviews and leave-behind questionnaires that included spouses and cohabitating partners. They used an adapted Montreal Cognitive Assessment (MoCA) to classify participants into normal, mild cognitive impairment, and dementia categories.

Their analysis showed:

  • Of all home-dwelling people with dementia, 46% of men and 18% of women were sexually active
  • Of home-dwelling partnered people with dementia, 59% of men and 51% of women were sexually active
  • Many men and women — including 74% of men and 38% of women with dementia — regarded sex as an important part of life
  • More than one-third of men and one in 10 women with dementia reported bothersome sexual problems, especially lack of interest in sex
  • About one in 10 people of both sexes felt threatened or frightened by a partner
  • More men (17%) than women (1%) with dementia spoke with a doctor about sex
  • The likelihood of sexual activity was lower among partnered people with worse cognitive function

“Physicians need to balance the dignity and autonomy of the person with dementia who desires sex with the need to protect the person from harm,” said Lindau, who posted a blog with resources for clinicians seeking guidance about sexual consent. “Our study tells physicians that sexual activity is common among home-dwelling people with dementia and should not be ignored or dismissed as an important aspect of life with dementia.”

This study has several limitations, the authors noted: the reliability of survey responses may decline with worse cognitive function. People with signs of overt dementia that was evident to the study interviewers were excluded. The study centered mainly on male-female partnerships and does not yield insights about same-sex relationships.

Complete Article HERE!

How Common Is Dementia Among LGBT Seniors?

By Robert Preidt

Dementia strikes about one in 13 lesbian, gay or bisexual seniors in the United States, a new study finds.

“Current estimates suggest that more than 200,000 sexual minorities in the U.S. are living with dementia, but — before our study — almost nothing was known about the prevalence of dementia among people in this group who do not have HIV/AIDS-related dementia,” said Jason Flatt. He is an assistant professor at the University of California, San Francisco School of Nursing.

The study included more than 3,700 lesbian, gay and bisexual adults, aged 60 and older. Over an average follow-up period of nine years, the rate of dementia in this group was 7.4 percent. The dementia rate among Americans aged 65 and older is about 10 percent.

The study was to be presented Sunday at the Alzheimer’s Association annual meeting, in Chicago.

The findings “provide important initial insights,” Flatt said in an association news release.

But “future studies aimed at better understanding risk and risk factors for Alzheimer’s and other dementias in older sexual minorities are greatly needed,” he added.

High rates of depression, high blood pressure, stroke and heart disease among sexual minorities may contribute to their dementia risk, the researchers say.

“Encouraging people to access health care services and make healthy lifestyle changes can have a positive impact on both LGBT and non-LGBT communities,” said Sam Fazio, director of quality care and psychosocial research for the Alzheimer’s Association.

But effective outreach to LGBT groups must be sensitive to racial, ethnic and cultural differences, Fazio added. This could result in earlier diagnosis, which has been linked to better outcomes, he said.

Flatt added that the study points to important implications for meeting the long-term caregiving needs of the LGBT community.

“Given the concerns of social isolation and limited access to friend and family caregivers, there is a strong need to create a supportive health care environment and caregiving resources for sexual minority adults living with dementia,” Flatt said.

Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

Complete Article HERE!