Focused Discussions II
For work that is best discussed or debated, rather than reported on through a formal presentation, these sessions provide a forum for an extended “roundtable” conversation between an author and a small group of interested colleagues. Summaries of the author’s key ideas, or points of discussion, are used to stimulate and guide the discourse.
Seniors, Sex, and Dementia: Creating a New Paradigm and Protecting Quality of Life
Focused Discussion Lawrence Siegel
Very little consideration is given to sexual and erotic expression or intimate relationships among the elderly. The aging population continues to change and sexual and intimate connections remain important quality of living issues for a majority of those over 65. Those working with aging populations over the next twenty years will contend with issues never before seen, from sexual medicine (eg, Viagra, Cialis, flibanserin), technology (eg, social and dating apps, porn), and greater acceptance of such issues as non-committed sexual relationships, same-sex relationships and erotic play, transgender/transsexual individuals, and a more open view of sexuality in general. Understanding and accommodating these issues is confounded by a pervasive fear and lack of understanding of different forms of dementia and whether such individuals have the capacity to consent to sexual activity. This workshop will present information on how our aging populations are changing and how these changes can be accommodated in elder and care communities. Participants will also discuss dementia and how sexual and intimate contact for those so diagnosed are still entitled to intimacy and erotic expression without ascribing a label of abuse. Participants will also be presented with an overview of some common issues with age-related changes, illness and disability, as well as effects of select medications. The last part of the workshop will include discussion and brainstorming about how we can develop policies and procedures to help create environments that are understanding and accommodating of the erotic and intimacy needs of older adults.
Sexual Function in Women with Multiple Sclerosis
Focused Discussion Rana Salem, Dagmar Amtmann, Alyssa Bamer, Kevin Alschuler, Mara Nery Hurwit, Katie Singsank, Kevin Weinfurt
This session examines sexual function (SexFS) in women with MS as compared to sexually active U.S. general population and the relationship between MS symptoms and SexFS. Paper surveys included the following PROMIS domains and items: interest in sex (interest), satisfaction with sex life (satisfaction), interference of pain and fatigue with sex (pain- & fatigue-interference), orgasm ability (orgasm), vaginal lubrication (lubrication), pain during sex, pain intensity and interference, and fatigue. M=50 represents the average for sexually active U.S. adults. Descriptives, t-tests, and regressions were used. Women with MS (n=479) were an average age of 60 years, 88% white, and 61% married. Participants who were sexually inactive in the past month (52%) reported more fatigue, pain interference, and pain intensity than sexually active women (all p<.05). Of those sexually active: 24% reported moderate to severe pain during sex; 15% reported pain and 22% reported fatigue interfered with sexual satisfaction quite a bit to very much. Satisfaction (M=47.6, SD=8.2), orgasm (M=45.4, SD=12.2), and lubrication (M=45.1, SD=10.1) scores were lower than U.S. population (all p<0.0001). After adjusting for depression, pain intensity was associated with lower interest (p=0.002). Pain during sex was negatively associated with satisfaction, orgasm, and lubrication, after controlling for pain intensity and depression (all p<.05). Fatigue was not a unique predictor of SexFS domains. Fatigue and pain contribute to less sexual activity and greater sexual difficulties in women aging with MS. More research is needed to better understand sexual function of women with MS and to develop interventions.
Elderly Suicide and Generational Exploitation in Rural China
Focused Discussion Jingxi Deng
Elderly suicide has become an increasingly social problem in mainland China. This study analyzes the suicide of rural elderly people from the perspective of social competition and intergenerational relations. Through fieldwork, the imbalance of resource allocation caused by social differentiation has been observed. Rather unprivileged peasants are more likely to transfer the pressure of social competition to the elderly family members through intergenerational exploitation. Once the elderly can no longer create value, cannot take care of themselves, or suffer from disease, they become a burden and cumbersome to their descendants; thus they are apt to commit suicide for the pressure and also the consideration of the younger generation. Their value is determined by the cost and benefit in taking care of them. Meanwhile, in order to justify the exploitation towards the elder generation since it’s against traditional Chinese morality, the mechanism of “demoralization” came into being through the daily language of fellow villagers. This has eased the moral burden on the younger generation and made it “normal” to treat the elderly in such a way.
Changing Aging Policy - from Burden to Asset
Focused Discussion Zvi Lanir
Based on fifteen years of research, reinforced by neurological, medical and human developmental psychology, and current data, this paper argues that there is a need for a fundamental shift in the way governments formulate aging policy and legislation on a variety of issues, ranging from retirement, health care, and human resources policies to broader questions of social change and generational issues.
