Module 1.1
Facts about Ageing
Sexuality and Intimacy
Topic Overview
This topic explores the fascinating, interrelated areas of human sexuality and intimacy, facts about ageing, health and sexual education, information literacy and focusing mainly on the expressing importance of sexuality for healthy life and intimacy in old age. Since this curriculum is developed within the EU project EduSexAge we will take a firmly international perspective, locating key theories of sexuality and intimacy in their cultural and historical perspective, and unpicking the limitations of such foundations by close, critical examination of global trends, meanings and experiences.
Aims and objectives
Learning outcomes
Having successfully completed this topic you will be able to:
- Understand the meaning of sexuality and practices of intimacy.
- Understanding basic facts about ageing and the importance to accept changes.
- Understand the importance of health and sexual education in connection to information literacy and vice versa.
- Recognize the importance of sexuality for a healthy and happy life.
- To give an account of the interactions of power in how sexuality and intimacy are researched, understood, practiced, and idealised in society and culture.
- Identify, and offer a critical response to key theories of sexuality and intimacy.
Ageing: What to expect
We all know that one of the first things which we notice in aging are wrinkles and grey hair. However, all sorts of changes are happening with our bodies while we age, namely aging affect our teeth, heart and sexuality? In this model you will learn what changes to expect as you continue aging — and how can you promote good health at any age.
Cardiovascular system
When we are getting old the most common change in the cardiovascular system is stiffening of the blood vessels and arteries. This is causing our heart to work harder to pump blood through them. The heart muscles change to adjust to the increased workload. Your heart rate at rest will stay about the same, but it won’t increase during activities as much as it used to. These changes increase the risk of high blood pressure (hypertension) and other cardiovascular problems (Mayo clinic, 2023).
What to do to promote heart health?
Try to stay physically active every day and make physical activity a daily routine. You can stay active with walking, swimming or other activities you enjoy. Regular moderate physical activity can help you maintain a healthy weight and lower your heart disease risk.
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Organize your meals in such a way that you choose vegetables, fruits, whole grains, high-fiber foods, and lean sources of protein, such as fish. Limit foods high in saturated fat and salt.
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If you smoke or use other tobacco products it contributes to the hardening of your arteries and increases your blood pressure and heart rate. if you smoke, talk to your personal doctor as soon as possible and prepare a plan to quit smoking.
Stress has a negative effect on your heart, so take measures to reduce stress, such as meditation, exercise or talk therapy.
Quality sleep plays an important role in the healing and repair of your heart and blood vessels. Try to sleep at least 7-9 hours a night.
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Bones, joints and muscles
With age, bones tend to shrink in size and density, weakening them and making them more susceptible to fracture. It could happen that you even become a bit shorter. Muscles generally lose strength, endurance and flexibility — factors that can affect your coordination, stability and balance (Mayo clinic, 2023).
What to do to promote bone, joint and muscle health?
Your body needs calcium to build strong bones when you’re young and to keep bones strong as you get older. Everyone needs calcium, but it’s especially important for women and girls. Many people — including more than half of all women — don’t get enough calcium. The recommended amount is at least 1,000 milligrams (mg) of calcium daily for adults. The recommendation increases to 1,200 mg daily for women age 51 and older and men age 71 and older. Calcium can help prevent osteoporosis (weak bones). Dietary sources of calcium include dairy products, broccoli, kale, salmon and tofu. If you find Accordion #2 it difficult to get enough calcium from your diet, ask your doctor about calcium supplements (Office of disease prevention and health promotion, 2023).
The recommended daily intake of vitamin D is 600 international units for adults up to age 70 and 800 IU for adults over 70. Many people get adequate amounts of vitamin D from sunlight. Other sources include tuna, salmon, eggs, vitamin D-fortified milk and vitamin D supplements.
Weight-bearing exercises, such as walking, jogging, tennis, climbing stairs and weight training can help you build strong bones and slow bone loss.
Try to avoid smoking and limit alcoholic drinks. Consult your doctor about how much alcohol might be safe for your age, sex and general health.
Digestive system
Constipation can occur in the elderly due to structural changes in the large intestine as a result of aging. Constipation can also occur due to insufficient physical activity, insufficient fluid intake and consumption of foods with a low fiber content. Medications, such as diuretics and iron supplements, and certain medical conditions, such as diabetes, can also contribute to constipation (Mayo clinic, 2023).
What to do to prevent constipation?
- Eat a healthy food – make sure your diet includes high-fiber foods, such as fruits, vegetables and whole grains. Limit high-fat meats, dairy products and sweets, which might cause constipation.
- Drink plenty of water and other fluids – try to drink at least 1,7 litres of water per day
- Include physical activity in your daily routine– be regularly physically active as physical activity can help prevent constipation.
- Don’t ignore the urge to have a bowel movement. Holding in a bowel movement for too long can cause constipation.
Bladder and urinary tract
As the bladder ages, it becomes less elastic, causing the need to urinate more often. Weakness of the bladder and pelvic floor muscles can make it difficult to empty the bladder completely or cause loss of bladder control (urinary incontinence). In men, an enlarged or inflamed prostate can also cause difficulty emptying the bladder and incontinence.
Other factors that contribute to incontinence include being overweight, nerve damage from diabetes, certain medications, and caffeine or alcohol consumption (Mayo clinic, 2023).
What to do to promote bladder and urinary tract health?
- Regularly use the toilet regularly – Try to urinate regularly, such as every hour. Slowly increase the time between toilet visits.
- Maintain a healthy weight – If you are overweight, try to lose weight
- Don’t smoke – if you smoke or use other tobacco products talk to your personal doctor as soon as possible and prepare a plan to quit smoking.
- Do Kegel exercises – to exercise your pelvic floor muscles (Kegel exercises), squeeze the muscles you would you use to stop passing gas. Try it for three seconds at a time, and then relax for a count of three. Work up to doing the exercise 10 to 15 times in a row, at least three times a day.
- Avoid bladder irritants – do not drink liquids containing caffeine, do not eat acidic food, do not drink alcohol and carbonated drinks, because they worsen incontinence.
- Avoid constipation. Eat more fiber and take other steps to avoid constipation, which can worsen incontinence.
Memory and thinking skills
As we age, the brain undergoes changes that may have minor effects on our memory or thinking skills. For example, healthy older adults may forget familiar names or words, or find it more difficult to multitask (Mayo clinic, 2023).
What to do to promote cognitive health?
When you are physically active this increases blood flow to your whole body, including your brain. Regular exercise is associated with better brain function and reduces stress and depression — factors that affect memory.
When eating healthy this could benefit your brain. Focus on fruits, vegetables and whole grains. Choose low-fat protein sources, such as fish, lean meat and skinless poultry. If you consume too much alcohol this can lead to confusion and memory loss.
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When staying mentally active this may help sustain your memory and thinking skills. You can read, play word games, take up a new hobby, take classes, or learn to play an instrument.
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When being socially active this helps ward off depression and stress, which can contribute to memory loss. Why not be active in a local community as a volunteer, spending as much time possible with family and friends, or attend social events.
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Follow doctor’s recommendations how to manage cardiovascular risk factors — high blood pressure, high cholesterol and diabetes — that may increase the risk of cognitive decline.
Smoking can damage your cognitive health, avoid or quit smoking, which may help you stay healthier.
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Eyes and ears
Ageing can also affect our eyes and ears. We might have difficulty focusing on objects that are close up. It can happen that Our eyes become more sensitive to glare and may have difficulty adjusting to different levels of light. Aging also can affect your eye’s lens, causing clouded vision (cataracts) (Mayo clinic, 2023)..
Hearing may also gradually decrease. You may have trouble hearing high frequencies or following a conversation in a crowded room.
What to do to promote eye and ear health?
Follow your doctor’s instructions regarding the use of glasses, contact lenses, hearing aids and other corrective aids.
Always wear sunglasses or a wide-brimmed hat when you’re outdoors, and use earplugs when you’re around loud machinery or other loud noises.
Teeth
Certain medications, such as medications for allergies, asthma, high blood pressure, and high cholesterol, can also cause dry mouth. Also, teeth and gums can become slightly more susceptible to decay and infection. Your gums may pull away from your teeth (Mayo clinic, 2023).
What to do to promote oral health?
Brush your teeth twice a day, and clean the space between your teeth — using regular dental floss or an interdental cleaner — once a day.
Visit your dentist or dental hygienist for regular dental checkups.
Skin
With ageing our skin thins and becomes less elastic and more fragile, and fatty tissue just below the skin decreases. Many times this is why you bruise more easily. Decreased production of natural oils might make your skin drier. Wrinkles, age spots and small growths called skin tags are more common (Mayo clinic, 2023).
What to do to promote healthy skin?
When using a bath or shower use warm — not hot — water. Use mild soap and moisturizer.
Use sunscreen and wear protective clothing when you’re outdoors,. Check your skin regularly and report changes to your doctor.
If you smoke or use other tobacco products talk to your personal doctor as soon as possible and prepare a plan to quit smoking. Smoking contributes to skin damage, such as wrinkling.
Weight
Calorie consumption (metabolism) slows down in old age. It means that if you reduce your activities in old age, but continue to eat the same as usual, you will gain weight. To maintain a healthy weight, stay active and eat healthy (Mayo clinic, 2023).
What to do to maintain healthy weight?
- Be physical active every day – moderate physical activity regularly, which can help you maintain a healthy weight.
- Eat a healthy food – choose vegetables, fruits, whole grains, high-fiber foods and lean sources of protein, such as fish. Limit sugar and foods high in saturated fat.
- Watch your portion sizes – to cut calories, keep an eye on your portion sizes.
Sexuality
In old age, sexual needs and performance can also change. This is affected by both illness and medication. Women face a dry vagina, which can cause discomfort during sex. Men, however, can experience impotence, and it may also take longer to achieve an erection that may not be as firm as when you were young (Mayo clinic, 2023).
What to do to promote sexual health?
- Be honest with your partner and talk about needs – an honest conversation about wants and needs may result in you finding that physical intimacy without sex is enough. Or you will experiment with different sexual activities.
- Be physically active regularly – workout can improves the release of sexual hormones, cardiovascular health, flexibility, mood and self-image — all factors that contribute to good sexual health.
- Discuss your concerns with your doctor – your doctor might offer specific treatment suggestions — such as estrogen cream for vaginal dryness or oral medication for erectile dysfunction in men.
Glossary & Acronyms
Active Ageing – is defined by the World Health Organization (WHO) as the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. It allows people to realise their potential for wellbeing throughout their lives and to participate in society according to their need, desires and capabilities, while providing them with adequate protection, security and care when they need assistance. There is currently no content classified with this term (AGE Platform Europe, 2023).
Module 1.2
Health and Sexual Education Literacy
The importance of sexual education
Since the fact that elderly people can be at high risk for acquiring a sexually transmitted diseases (STD), this issue should be raised as often as possible. Lack of adequate education can result in social stigmatization, lack of awareness of risks, or generational norms that prevent older people from talking openly about sexuality. In their youth, they were worried about getting pregnant, possible infection with a STD, so the talking about this topic is a new field for many older people. This is why educating older people about healthy behaviours, testing, and treatment options is extremely important (Potyraj, 2016).
These include:
- Reinforcement by talking to health personnel about sexual health.
- Talking to a potential sexual partner about their sexual history before having sexual intercourse.
- Practicing monogamy or limitation of the number of sexual partners.
- Consent and agreement regarding testing of both partners for STD before sexual intercourse.
- Consistency in sexual relations in case of consumption of substances (e.g., alcohol) that can impair judgement.
- Regular use of a contraceptive such as condoms and lubricant.
- Rapid action in case of suspicion of STD (health treatment).
- Raising awareness through the public, health professionals, and family members whom the elderly trust about the sexual health, who consequently play a key role in optimizing the quality of life of older adults (Potyraj, 2016).
Knowledge and attitudes towards sexuality contribute significantly to reducing stereotypes about this aspect of the lives of older people, so it is important not only to educate the elderly, but also those who educate the elderly. A study conducted at faculties (medicine, nursing, occupational therapy, physiotherapy, psychology and social work) regarding knowledge and attitudes about sexuality in aging showed that age is the only demographic factor that can predict attitudes towards sexuality and knowledge sexuality. The study did not reveal main effects for differences in generally above-average levels of knowledge and attitudes between professions and the three countries where study was conducted (Australia, New Zealand and South Africa), but it did show that the level of knowledge and attitudes about sexuality improved compared to previous studies (Helmes & Chapman, 2011).
Health education
Health education is a concept directly related to health promotion, however, opportunities to promote health have generally been neglected (Choi et al., 2010). Health education increases an individual’s knowledge about health and awareness of their health decisions (Kececi, A., & Bulduk, 2012). Promoting the health and well-being of the individual is a major responsibility, especially for those working with the elderly. The concept of well-being does not only apply to younger generations, but to all generations, including the elderly (Reicherter & Greene, 2005; Tabloski, 2010). Health education is based on knowledge, on careful handling of relationships, perception, social status, power structure, cultural practice and other social aspects. Health education is not a concept about individuals or their families, but it can have a profound effect on social status of individuals (Glanz et al., 2008).
Media and Information literacy
Media and information literacy is the key to ensuring the rights of the elderly to participate in the digital age. In this way the digital era can also be elderly people’s era (Hermans, 2022). We live in a time of rapidly growing digitization and digital technologies effectively help with learning new skills, promoting social interactions, and independent and autonomous living. With the help of technology, we manage our own health more easily and also access health and social services more quickly. Also, the COVID-19 pandemic, when the face-to-face meetings was limited, has shown that the use of telehealth is an effective method in provision of health care. But it is a fact that access to digital technologies in and within populations differ (Hermans, 2022).
For effective inclusion in digital technology, we need, of course, reliable access to the use of ICT, but this is not enough. We also need digital skills and a positive attitude to be able to adapt to technological opportunities (Center for Ageing Better, 2021). Representatives of the Age Platform Europe which represents the voice of older persons at EU level thinks that average digital literacy training for the elderly mainly focuses on skills to use digital tools, but not focusing at all on understanding digital content (Age Platform Europe, 2020).
Information literacy is very important to be able to recognize fake news, which fall into three categories:
- disinformation is false information shared with good intentions;
- disinformation or “fake news” and “hoaxes” are spread intentionally;
- false information or “gossip”, may be true information, but is spread by someone with the intention of causing harm to another.
Why elderly should care and what they can do?
The elderly are more likely to live with one or more chronic diseases and there is a greater risk to their health from fake and false news. Fake news misleads older people, additionally it can mislead people about how to stay safe, reduce trust in the media and increase anxiety (Age Platform Europe, 2020).
Older people should make sure they seek information from reliable sources. If they are unsure of the reliability of a source, they should check the same information on the Internet (or any other source of information) to see if more than one source is reporting the same thing in the same way. If you come across misinformation, just report it to the social media platform where you found it (you can also contact the author who published some information, as it was probably done unintentionally) (Age Platform Europe, 2020).
Glossary & Acronyms
- Digital literacy – covers the skills required to achieve digital competence, the confident and critical use of the information and communication technologies (ICTs) for work, leisure, learning and communication.
- Digital health – Digital health is the term gathering health services accessed through or provided with the assistance of Information and communications technologies (ICTs).
- Digital divide – Digital divide is the gap that exists between people or countries regarding the extent of access to Information and communications technologies (ICTs).
- Health literacy – Health literacy is people’s knowledge, motivation and competence to access, understand, appraise and apply health information, make judgments and take decisions regarding their health and wellbeing.
- ICT – Information Communication Technology (AGE Platform Europe, 2023
Module 1.3
Sex for Healthy Life
Elderly people and Sexual Health: Why Sex is the Best Remedy
The Canadian Association of Obstetricians and Gynaecologists lists some of the benefits that accompany sexual activity in old age, namely:
- During sex, we lose fat and strengthen the immune system;
- During sex, the brain releases endorphins – natural pain relievers in the body;
- With sex, we relieve the body of stress and take care of our well-being;
- During an active sex life, we have higher levels of naturally produced sex hormones in the body;
- In sexually active people, the physical changes that occur with aging may be less pronounced;
- There are many ways to be physically intimate, and they all contribute to your health and well-being;
- Sex takes about as much energy as walking up two flights of stairs, so sex is rarely dangerous to your health.
- Being sexually active contributes to improving physical and emotional health.
ATTENTION: If you have any health concerns, consult your doctor or healthcare professional; Just remember that sexually transmitted infections (STIs) know no age limits; so if you are sexually active, always practice safe sex (Nurse next door, 2020).
Additional benefits:
- Sex is an anti-aging agent, which is an additional reason to maintain your sexual activity.
- You can reduce the risk of incontinence by being sexually active.
- If you are sexually active, you will relax your body and calm your mind, which will have a positive effect on your sleep.
- Sex reduces the risk of prostate cancer and lowers blood pressure by opening and relaxing blood vessels.
- Sex also releases human growth hormones, and along with the secretion of some estrogen and testosterone, contributes to maintaining skin elasticity, reducing wrinkles, firming muscles, glowing skin and softer hair.
Let’s also not forget the emotional and spiritual benefits, as sex supplies our brain with endorphins and oxytocin, which leads to a general improvement in mood, attitude and outlook on life.
Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them.
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