SEXUAL EXPERIENCES OF ELDERLY INDIVIDUALS WITH PHYSICAL DISABILITIES AND THEIR WELL-BEING

Year 2023, Volume: 6 Issue: 1, 17 - 44, 30.06.2023

Ali Taşci , Doç. Dr. Taner Artan , Büşra Uslu Ak

https://doi.org/10.54467/trjasw.1293071

Abstract

Elderly individuals with physical disabilities (EIPD) are subject to the same rights and freedoms as the general population in the context of sexuality. However, the elements of social norms and religion may cause EIPD to experience sexuality differently. The approaches of health and social care institutions, the attitudes of families and caregivers, and the level of interest of the relevant occupational groups can affect the sexual well-being of the individuals. This study is a phenomenological research based on the personal experiences of EIPD. The results indicate that the participants consider themselves adequate or partiallyadequate with their knowledge on sexuality. The sexual well-being of the participants is negatively affected by aging and disability. The participants do not think they have freedom of expression and they experience discrimination from close circle. The study concludes that the sexual life of EIPD is limited or shaped by social norms, values, beliefs and religion.

Keywords

Elderly Individuals with Physical Disabilities, Sexual Experiences, Sexuality, Well-being

References

• AÇSB. (2019). Engelli ve Yaşlı Bülteni 2019. Retrieved from Ankara: https://ailevecalisma.gov.tr/tr-tr/haberler/engelli-ve-yasli-bireylere-iliskin-istatistikbulteni-yayinlandi Adams, T. B., Bezner, J., Drabbs, M. E., & Zambarano, R. J. (2000). Conceptualization and Measurement of the Spiritual and Psychological Dimensions of Wellness in a College Population. Journal of American College Health, 48(4), 165-173. doi:10.1080/07448480009595692
• Addlakha, R., Price, J., & Heidari, S. (2017). Disability and Sexuality: Claiming Sexual and Reproductive Rights. Reprod Health Matters, 25(50), 4-9. doi:10.1080/09688080.2017.1336375
• Aggleton, P., & Parker, R. (2010). Routledge Handbook of Sexuality, Health and Rights. New York: Routledge.
• Arias-Castillo, L., Ceballos-Osorio, J., Ochoa, J. J., & Reyes-Ortiz, C. A. (2009). Correlates of Sexuality in Men and Women Aged 52–90 Years Attending a University Medical Health Service in Colombia. Journal of Sexual Medicine, 6(11), 3008-3018. doi:10.1111/j.1743- 6109.2009.01488.x
• Aunos, M., & Feldman, M. A. (2002). Attitudes towards Sexuality, Sterilization and Parenting Rights of Persons with Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities, 15, 285-296. doi:10.1046/j.1468-3148.2002.00135.x
• Bauer, M., McAuliffe, L., & Nay, R. (2007). Sexuality, Health Care and the Older Person: An Overview of the Literature. International Journal of Older People Nursing, 2, 63-68. doi:10.1111/j.1748-3743.2007.00051.x
• Beckman, N., Waern, M., Gustafson, D., & Skoog, I. (2008). Secular Trends in Self Reported Sexual Activity and Satisfaction in Swedish 70 Year Olds: Cross Sectional Survey of Four Populations, 1971-2001. Bmj-British Medical Journal, 337, 1-7. doi:10.1136/bmj.a279
• Bierman, A., & Statland, D. (2010). Timing, Social Support, and the Effects of Physical Limitations on Psychological Distress in Late Life. Journals of Gerentology: Series B, 65(5), 631-639. doi:10.1093/geronb/gbp128
• Blieszner, R. (2001). She’ll be on My Heart: Intimacy among Friends. Generations, 25(2), 48-54.
• Bouman, W. P., Arcelus, J., & Benbow, S. M. (2007). Nottingham Study of Sexuality and Ageing (NoSSA II). Attitudes of Care Staff Regarding Sexuality and Residents: A study in Residential and Nursing Homes. Sexual and Relationship Therapy, 22(1), 45-61. doi:10.1080/14681990600637630
• Bywater, J., & Jones, R. (2007). Sexuality and Social Work: Transforming Social Work Practice. Glasgow: Learning Matters.
• Camacho, M., & Reyez-Ortiz, C. (2005). Sexual Dysfunction in the Elderly: Age or Disease? International Journal of Impotence Research, 17, 52-56. doi:10.1038/sj.ijir.3901429
• Caputo, J., & Simon, R. W. (2013). Physical Limitation and Emotional Well-Being: Gender and Marital Status Variations. Journal of Health and Social Behavior, 54(2), 241-257. doi:10.1177/0022146513484766
• Chandani, A. T., McKenna, K. T., & Maas, F. (1989). Attitudes of University Students towards the Sexuality of Physically Disabled People. British Journal of Occupational Therapy, 52(6), 233-236. doi:10.1177/030802268905200609
• Chou, Y. C., & Lou, Z. Y. (2011). Deciding about sterilization: Perspectives from women with an intellectual disability and their families in Taiwan. Journal of Intellectual Disability Research, 55, 63-74. doi:10.1111/j.1365-2788.2010.01347.x.
• Coleman, E. M., & Murphy, W. D. (1980). A Survey of Sexual Attitudes and Sex Education Programs Among Facilities For The Mentally Retarded. Applied Research in Mental Retardation, 1(3-4), 269-276. doi:10.1016/0270-3092(80)90009-0
• Creswell, J. W. (2007). Qualitative Inquiry & Research Design: Choosing Among Five Approaches (2 ed.). California: SAGE Publications.
• Creswell, J. W. (2014). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches (4 ed.). California: SAGE Publications.
• Creswell, J. W., & Poth, C. N. (2018). Qualitative Inquiry Research Design: Choosing Among Five Approaches (4 ed.). Los Angeles: SAGE Publications.
• Deacon, S., Minichiello, V., & Plummer, D. (1995). Sexuality and Older People: Revisiting The Assumptions. Education Gerontology, 21, 497-513. doi:10.1080/0360127950210509
• DeLamater, J. D., & Koepsel, E. (2014). Relationships and Sexual Expression in Later Life: A Biopsychosocial Perspective. Sexual and Relationship Therapy, 30(1), 37-59. doi:10.1080/14681994.2014.939506
• Diener, E. (2009). The Science of Well-Being. Canada: Springer.
• Diener, E., & Biswas-Diener, R. (2005). Psychological Empowerment and Subjective Well-being. In D. Narayan (Ed.), Measuring Empowerment : Cross Disciplinary Perspectives (pp. 125- 140). Washington: World Bank.
• DiGiulio, G. (2003). Sexuality and People Living with Physical or Developmental Disabilities: A Review of Key Issues. The Canadian Journal of Human Sexuality, 12(1), 53-64.
• Dunn, H. L. (1959). What High-Level Wellness Means. Canadian Journal of Public Health, 50(1), 447-457.
• Dunn, M. H., & Cutler, N. (2000). Sexual Issues in Older Adults. AIDS Patient Care, 14(2), 67- 69. doi:10.1089/108729100317984
• Evans, D. S., McGuire, B. E., Healy, E., & Carly, S. N. (2009). Sexuality and Personal Relationships for People with an Intellectual Disability. Part II: Staff and Family Carer Perspectives. Journal of Intellectual Disability Research, 53, 913-921. doi:10.1111/j.1365.2788.2009.01202.x
• Ezzy, D. (2002). Qualitative Analysis: Practice and Innovation. Australia-Crows Nest: Psychology Press.
• Fahey, T. D., Insel, P. M., & Roth, W. T. (2014). Fit & Well : Core Concepts and Labs in Physical Fitness and Wellness. New York: McGraw-Hill Education.
• Fairchild, S. K., Carrino, G. E., & Ramirez, M. (1996). Social Workers’ Perceptions of Staff Attitudes Toward Resident Sexuality in a Random Sample of New York State Nursing Homes: A Pilot Study. Journal of Gerontological Social Work, 26(1-2), 153-169. doi:10.1300/J083V26N01_10
• Ferrini, A. F., & Ferrini, R. L. (2008). Health in the Later Years. Boston: McGraw-Hill. Gott, M., & Hinchliff, S. (2003). How Important is Sex in Later Life? The Views of Older People. Social Science & Medicine, 56(8), 1617-1628. doi:10.1016/s0277-9536(02)00180-6
• Greenberg, J. S., & Dintiman, G. B. (1995). Physical Fitness and Wellness. Boston: Allyn and Bacon.
• Haesler, E., Bauer, M., & Fetherstonhaugh, D. (2016). Sexuality, Sexual Health and Older People: A Systematic Review of Research on the Knowledge and Attitudes of Health Professionals. Nurse Education Today, 40, 57-71. doi:10.1016/j.nedt.2016.02.012
• Healy, J. C. (2020). ‘It Spreads like a Creeping Disease’: Experiences of Victims of Disability Hate Crimes in Austerity Britain. Disability & Society, 35(2), 176-200. doi:https://doi.org/10.1080/09687599.2019.1624151
• Johnson, B. K. (1998). A Correlational Framework for Understanding Sexuality in Woman Age 50 and Older. Health Care for Women International, 19, 553-564. doi:10.1080/073993398246115
• Lam, W. Y. (2010). Validated Instruments Used to Measure Attitudes of Healthcare Students and Professionals towards Patients with Physical Disability: A Systematic Review. Journal of NeuroEngineering and Rehabilitation, 7(55), 1-7. doi:10.1186/1743-0003-7-55.
• LeCompte, M., & Goetz, J. P. (1982). Problems of Reliability and Validity in Ethnographic Research. Review of Educational Research, 52(1), 31-60. doi:10.2307/1170272
• Lee, S., Fenge, L., & Collins, B. (2020). Disabled People’s Voices on Sexual Well-being. Disability & Society, 35(2), 303-325. doi:https://doi.org/10.1080/09687599.2019.1634522
• Leigh, I., Powers, L., Vash, C., & Nettles, R. (2004). Survey of Psychological Services to Clients With Disabilities: The Need for Awareness. Rehabilitation Psychology, 49(1), 48-54. doi:10.1037/0090-5550.49.1.48
• Lichtenberg, P. A. (2010). Handbook of Assessment in Clinical Gerontology (2 ed.). London: Elsevier.
• Lindau, S. T., Laumann, E. O., & O’Muircheartaigh, C. A. (2007). A Study of Sexuality and Health among Older Adults in the United States. The New England Journal of Medicine, 357(8), 762-774. doi:10.1056/NEJMoa067423
• Loe, M. (2004). Sex and the Senior Woman: Pleasure and Danger in the Viagra Era. Sexualities, 7(3), 303–326. doi:10.1177/1363460704044803
• Maes, C. A., & Louis, M. (2011). Nurse Practitioners’ Sexual History-Taking Practices with Adults 50 and Older. The Journal for Nurse Practitioners, 7(3), 216-222. doi:10.1016/j.nurpra.2010.06.003
• Mahieu, L., Van Elssen, K., & Gastmans, C. (2011). Nurses’ Perceptions of Sexuality in Institutionalized Elderly: A Literature Review. International Journal of Nursing Studies, 48(9), 1140-1154. doi:10.1016/j.ijnurstu.2011.05.013
• Malhotra, S., Khurshid, A., Hendricks, K. A., & Mann, J. R. (2008). Medical School Sexual Health Curriculum and Training in the United States. Journal of the National Medical Association, 100(9), 1097-1106. doi:10.1016/s0027-9684(15)31452-8
• Maslow, A. H. (1943). A Theory of Human Motivation. Psychological Review, 50, 370-396.
• McCabe, M. P., Telepros, G., & Dip, G. (2003). Sexual Esteem, Sexual Satisfaction, and Sexual Behavior among People with Physical Disability. Archives of Sexual Behavior, 32(4), 359- 369. doi:10.1023/a:1024047100251
• Mertens, D. M. (2009). Research and Evaluation in Education and Psychology: Integrating Diversity With Quantitative, Qualitative, and Mixed Methods (3 ed.). California: SAGE Publications.
• Metz, M. E., & Miner, M. H. (1998). Psychosexual and Psychosocial Aspects of Male Aging and Sexual Health. The Canadian Journal of Human Sexuality, 7(3), 245-260.
• Minihan, P. M., Robey, K. L., Long-Bellil, L. M., Graham, C. L., Hahn, J. E., Woodard, L., & Eddey, G. E. (2011). Desired Educational Outcomes of Disability-Related Training for the Generalist Physician: Knowledge, Attitudes, and Skills. Academic Medicine, 86(9), 1171- 1178. doi:10.1097/ACM.0b013e3182264a25.
• Moore, T. N. (2011). Race, Sexual Desire, Sexual Activity and Sexual Satisfaction among Older Adults. (Doctor of Philosophy), Tennessee State University, Tennessee.
• NASW. (1996). Code of Ethics. Retrieved from Washington: https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
• NCD. (2009). The Current State of Health Care for People with Disabilities. Retrieved from Washington: https://www.ncd.gov/publications/2009/Sept302009
• Neufeld, J. A., Klingbeil, F., Bryen, N., Silverman, B., & Thomas, A. (2002). Adolescent Sexuality and Disability. Physical Medicine and Rehabilitation Clinics of North America, 13(4), 857- 873. doi:10.1016/s1047-9651(02)00045-1
• Paim, L. (1995). Definitions and Measurements of Well-being: A Review of Literature. Journal of Economic and Social Measurement, 21(4), 297-309. doi:10.3233/JEM-1995-21403
• Pangman, V., & Seguire, M. (2000). Sexuality and the Chronically Ill Older Adult: A Social Justice Issue. Sexuality & Disability, 18(1), 49-65. doi:10.1023/A:1005477712133
• Parkes, N. (2006). Sexual Issues and People with a Learning Disability. Learning Disability Practice, 9(3), 32-37. doi:10.7748/ldp2006.04.9.3.32.c1660
• Penhollow, T. M. (2006). Activity, Aging & Sexuality: A Study of an Active Retirement Community. (Doctor of Philosophy), University of Arkansas, Arkansas.
• Pushkar, D., Chaikelson, J., Conway, M., Etezadi, J., Giannopoulus, C., Li, K., & Wrosch, C. (2010). Testing Continuity and Activity Variables as Predictors of Positive and Negative Affect in Retirement. The Journal of Gerontology Series B: Psychological Sciences and Social Sciences, 65(1), 42-49. doi:10.1093/geronb/gbp079
• Reitzes, D. C., & Mutran, E. (2006). Self and Health: Factors That Encourage Self-Esteem and Functional Health. Journals of Gerentology: Series B, 61(1), 44-51. doi:10.1093/geronb/61.1.S44
• Salice, A., & Schmid, H. B. (2006). The Phenomenological Approach to Social Reality: History, Concept, Problems. Switzerland: Springer.
• Schlesinger, B. (1996). The Sexless Years or Sex Rediscovered. Journal of Gerontological Social Work, 26(1-2), 117-131. doi:10.1300/J083V26N01_08
• Shuttleworth, R. P. (2000). The Search for Sexual Intimacy for Men with Cerebral Palsy. Sexuality and Disability, 18(4), 263-282. doi:10.1023/A:1005646327321
• SIECUS. (2012). National Sexuality Education Standards. Retrieved from Washington: https://siecus.org/resources/national-sexuality-education-standards/
• Sinclair, J., Unruh, D., Lindstrom, L., & Scanlon, D. (2015). Barriers to Sexuality for Individuals with Intellectual and Developmental Disabilities: A Literature Review. Education and Training in Autism and Developmental Disabilities, 50(1), 3-16.
• Smith, L., McDermott, D., & Jackson, S. (2019). New Research: Having Sex in Older Age Could Make You Happier and Healthier. Retrieved from Medical Xpress: https://medicalxpress.com/news/2019-09-sex-older-age-happier-healthier.html
• Snyder, C. R., & Lopez, S. J. (2002). Handbook of Positive Psychology. New York: Oxford University Press. Starr, B. D., & Weiner, M. B. (1982). The Starr-Weiner Report on Sex and Sexuality in the Later Years. New York: McGraw-Hill.
• Steinke, E. E. (1994). Knowledge and Attitudes of Older Adults about Sexuality in Ageing: A Comparison of Two Studies. Journal of Advanced Nursing, 19, 477-485. doi:10.1111/j.1365-2648.1994.tb01110.x
• Strike, D. L., Skovholt, T. M., & Hummel, T. J. (2004). Mental Health Professionals’ Disability Competence: Measuring Self-Awareness, Perceived Knowledge, and Perceived Skills. Rehabilitation Psychology, 49(4), 321-327. doi:10.1037/0090-5550.49.4.321
• Toubak, B. E. (2011). A Biopsychosocial Perspevtive on the Sexual Desire and Sexuality of Developmentally Disabled Individuals. (Doctor of Psychology), California Graduate Institute, California.
• Trudel, G., & Desjardins, G. (2000). Staff Reactions toward The Sexual Behaviors of People Living in Institutional Settings. Sexuality and Disability, 10(3), 173-188. doi:10.1007/bf01102283
• WAS. (2008). Declaration of Sexual Rights. Retrieved from Roma: http://www.emory.edu/UHS/WAS%20Declaration%20of%20Sexual%20Rights.pdf
• WHO. (2011). World Report on Disability 2011. Retrieved from Geneva: https://www.who.int/disabilities/world_report/2011/report.pdf
• WHO. (2017). World Health Statistics 2017: Monitoring Health for the SDGs, Sustainable Development Goals. Retrieved from Geneva: https://www.who.int/gho/publications/world_health_statistics/2017/en/ Woodard, W., & Rollin, S. (1981). Sexuality and the Elderly: Obstacles and Options. Journal of Rehabilitation, 47(4), 64-68.
• Yıldırım, A., & Şimşek, H. (2013). Sosyal Bilimlerde Nitel Araştırma Yöntemleri Ankara: Seçkin Yayıncılık.