• Communication and Education
  • Discuss normal age-related physiological changes.
  • Address how the effects of medications/medical conditions may affect one's sexual function.
  • Facilitate communication with older adults and their families regarding sexual health as desired, including:
    • Encourage family meetings with open discussion of issues if desired.
    • Teach about safe sex practices.
    • Discuss use of condoms to prevent transmission of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV).
• Health Management
  • Perform a thorough patient assessment.
  • Conduct a health history, review of systems, and physical examination.
  • Effectively manage chronic illness.
  • Improve glucose monitoring and control among diabetics.
  • Ensure appropriate treatment of depression and screening for depression (see the National Guideline Clearinghouse [NGC] summary of the Hartford Institute for Geriatric Nursing [HGNI] guideline Depression).
  • Discontinue/substitute medications that may result in sexual dysfunction (e.g., hypertension or depression medications).
  • Accurately assess and document older adults' ability to make informed decisions (see the NGC summary of the HGNI guideline Health Care Decision Making.
  • Participation in sexual relationships may be considered abusive if an older adult is not capable of making decisions.
• Sexual Enhancement
  • Compensate for normal changes of aging
    • Females:
      • Use of artificial water-based lubricants
      • Treatment of female sexual arousal disorder (FSAD) with sildenafil citrate (Viagra) (Berman et al., 2004).
      • Use of centrally acting serotonin agonists and vasodilating creams (Walsh & Berman, 2004).
    • Males:
      • Recognizing the possibility for more time and direct stimulation for arousal due to aging changes.
      • Use of sildenafil citrate (Viagra) for erectile dysfunction (Fink et al., 2002).
• Environmental adaptations
  • Ensure privacy and safety among long-term-care and community-dwelling residents (Wallace, 2003)

Definitions:

Levels of Evidence

Level I: Systematic reviews (integrative/meta-analyses/clinical practice guidelines based on systematic reviews)

Level II: Single experimental study (randomized controlled trials [RCTs])

Level III: Quasi-experimental studies

Level IV: Non-experimental studies

Level V: Care report/program evaluation/narrative literature reviews

Level VI: Opinions of respected authorities/Consensus panels

Reprinted with permission from Springer Publishing Company: Capezuti, E., Zwicker, D., Mezey, M. & Fulmer, T. (Eds). (2008) Evidence Based Geriatric Nursing Protocols for Best Practice, (3^rd ed). New York: Springer Publishing Company.

References open in a new window

Electronic copies: Available from the Hartford Institute of Geriatric Nursing Web site.

Copies of the book Geriatric Nursing Protocols for Best Practice, 3rd edition: Available from Springer Publishing Company, 536 Broadway, New York, NY 10012; Phone: (212) 431-4370; Fax: (212) 941-7842; Web: www.springerpub.com.

• Sexuality issues in aging: post-test instructions. Continuing education activity. Available from the Hartford Institute for Geriatric Nursing Web site.
• Sexuality issues in aging: evaluation. Continuing education activity. Available from the Hartford Institute for Geriatric Nursing Web site.

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