Aging and Sexual Health

I thoroughly enjoyed Friday’s lecture on aging and sexual health and felt like I learned information that is applicable for clients we might see in a variety of settings.  This topic is a sensitive one for many clients, so I appreciate the emphasis our speaker had on using the PLISSIT model to discuss sexual health with our future clients.  P stands for asking “permission” to talk about sexual health.  Since most clients will not discuss their sexual health with healthcare providers it might be important to ask, “Is there anything about your sexual health you would like to discuss?”  The occupational therapist can then give “limited information” (LI) if the client says he/ she would like to discuss sexual health such as “many clients have questions about sex after a joint replacement surgery,” and then giving limited information about their precautions and when it will be appropriate to resume sexual activities.  The OT can then proceed to give “specific suggestions” (SS) such as positions that can be better for the couple to not break precautions or irritate the incision site.  IT stands for “intensive therapy.”  If the client has serious concerns about his/ her sexual health that are outside the scope of OT practice, they can be referred to a sex therapist who can give intensive therapy on sexual health. 

One intervention that could be taught to an individual client is proper positioning.  For example, if a client has arthritis and lower back pain, some positions might be painful.  An occupational therapist can suggest different positions to alleviate their pain and allow them to complete this occupation while protecting their joints.  Positioning wedges can also be helpful to facilitate proper positioning. 

Another intervention that could be implemented with a group of older adults who have a chronic condition such as multiple sclerosis is teaching energy conservation techniques for sexual activity.  The four principles of energy conservation are prioritize, plan, pace, and position and posture.  These principles can be applied to sexual activity like they can for many other occupations.  The OT could teach the group to prioritize this occupation if it is very important to them and perform it at a time of the day when they have more energy.  The next step is to plan the time of the week when their schedule looks best to complete this occupation, such as a day when they do not have much work or other demanding tasks.  For the pace portion of energy conservation, clients can be encouraged to take breaks and take their time.  Before or after completing this activity, they might need to relax and rest for a while, and they can plan in their schedule to do so.  Position and posture are very important for many of the clients OTs see, and the occupational therapist can inform the group of various positions that can help them reduce strain on their joints and help them to reduce their exertion during this activity.  Assistive devices are an important component of energy conservation, and OTs can inform their groups of various devices that can make this activity easier as well.