Discussing sexuality with older patients

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Published: 23 Nov 2018
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Corien Eeltink - Amsterdam University Medical Center, Amsterdam, The Netherlands

Corien Eeltink speaks to ecancer at the International Society of Geriatric Oncology 2018 conference in Amsterdam about her work on patient sexuality in the context of older patients.

She discusses the lack of communication between healthcare professionals and older patients about their sexual activity, as healthcare professionals do not always consider older patients to be sexually active and the patients are often reluctant to discuss any sexual matters.

This taboo is problematic as any sexual impairment that is the result of illness or treatment may remain undetected, despite healthcare professionals being able to provide strategies that can help.

Corien concludes by proposing that this could be improved by better training healthcare professionals to discuss sexual health with patients.

This service has been kindly supported by an unrestricted grant from Janssen Oncology.

I’m doing a PhD at this moment about sexuality among haematological patients and I have interest in the care for older patients. I was asked to present research on sexuality and older patients so I needed to have a look in the literature myself. The problem is that a lot of healthcare professionals think that older patients are not being sexually active and older patients themselves they also think we are sexually active but we shouldn’t be because everybody thinks that older people are not sexually active anymore. So they feel a bit reluctant and ashamed to discuss sexual matters with their physician or with their nurse. So there’s a big taboo from the patients’ point of view but also from the healthcare professional’s point of view.

Still we know that older patients are sexually active and older patients, as the young patients, can have impaired sexual function because of the treatment we give for cancer patients. So it’s all the same as it is in the younger patients. We see a lot in common in the general population, sexual problems are quite common and the treatment for cancer adds risks for sexual dysfunction. So there must be a lot of sexual problems and that’s a pity because there are a lot of strategies that can help patients. I’m an advocate for talking about sexuality with the patients, also with older patients. So that’s my message. Every time I come to conferences I have to talk about sexuality.

What ways could we see this being improved?

Education, that is the problem because in our training for a nurse, I’m a nurse, but also in the training for medical doctors there’s hardly any attention for talking about topics like sexuality. So we learn about the anatomy and we learn about some problems that can occur but we do not learn how to discuss sexual health with our patients; that’s a big problem.

Is there anyone who could discuss this problem with medical professionals?

Talking about fertility, that’s not a problem; for a lot of doctors it’s not a problem. But talking about sexuality and sexual problems, there the problem starts. I don’t think geriatricians do it more often than oncologists or that nurses do it more often, most of them do not discuss about these issues and that has to do with our training. We could ask sexologists to train us.

It’s quite simple, actually. I told in my presentation what step-based model could help. First ask for permission to talk about it and then if the patient says, ‘Yes, okay, I’m willing to talk about this,’ give information about the causes and give information about the strategies that can help. It’s quite simple.