When Lisa Noll, 67, got divorced two years ago after 35 years of marriage, she thought relationships, romance and sex were a thing of the past. Now, she’s in a relationship with a man 10 years younger and has what she calls “a rich sex life.” “I didn’t think people had sex any more. I thought people got old and just stopped. It’s like a big secret,” said Noll, who splits her time between Colorado Springs, Colo., and Merida, Mexico. “I’m floored that I am having sex and a relationship and that it’s as good as it is. I’m a lot more confident now and know what I want.”
About 40% of people between ages 65 and 80 are sexually active, according to a survey from the National Poll on Healthy Aging, sponsored by AARP and the University of Michigan. A Pew Research Center study found that the number of older Americans between ages 55 and 64 who had used an online dating website or app doubled between 2013 and 2015. Some dating sites, such as those run by AARP and OurTime, cater specifically to singles 50 years and older. Given that 45% of Americans older than 65 are divorced, separated or widowed, according to AARP, there’s a lot of potential customers. “The baby boomers had to break down sexual barriers in the 60s and 70s and they’re silently doing it now. There’s a notion that if you turn 55, 60, 70, sex goes away. But it doesn’t. People are living longer and they’re having sex longer,” said John Portmann, author of the book “The Ethics of Sex and Alzheimer’s” and a professor of religious studies at the University of Virginia. “There are celebrities like Jane Fonda who say they’ve never stopped having sex. I think she sees herself as trying to liberate women and say that sex doesn’t stop.” Daniel Reingold, President and CEO of RiverSpring Living, the parent organization of the Hebrew Home at Riverdale, realized in the mid-‘90s that his organization needed a sexual expression policy when a nurse came up to him, rattled that a couple was having sex in a room and asked him what to do. Reingold’s organization then did a national survey of nursing homes on the topic of sex, created a policy and a staff training video that could be used by other nursing homes and assisted living centers. Since then, the policies have evolved and now include more discussion on LGBTQ issues. “What’s so shocking to me is that 25 years later, so many organizations and people are putting their heads in the sand on this topic of sex,” Reingold said. “The big issue in the room is ageism. People think that desire and libido go away at a certain age and to me that’s so ageist. Most of us think our parents are virgins and the idea of them having sex is disgusting to us. That’s just so wrong.” Touch tends to be among the last senses to decline, Reingold said, so the power of touch is incredibly rewarding for residents in assisted living, nursing homes or other facilities. “Whether it’s holding hands or snuggling or sex, the person is not looking at the other person as old and wrinkled. They’re looking at it as young love. The pleasure of touch can be the thing that makes a resident want to get up in the morning to see their girlfriend at breakfast, to continue to thrive,” Reingold said. Safer sex later in life Of course, there’s not just the rewards of intimacy, there’s also risks associated with sex in retirement years. According to the Centers for Disease Control and Prevention, between 2011 and 2015, chlamydia infections in Americans aged 65 and over increased by nearly 50%, and gonorrhea by 102%. Medicare offers free STD screenings for seniors, yet only 5% of those who are eligible for the service have chosen to use the service. Meanwhile, users of erectile dysfunction (ED) drugs have two-to-three times higher rates of STDs than do nonusers, Harvard researchers at Massachusetts General Hospital have found after analyzing insurance records of more than 1.4 million U.S. men over age 40. According to a National Survey of Sexual Health and Behavior, condoms are used in about 40% of sexual encounters among college-age Americans. But among those 61 and older, condoms are only used in about 6% of sexual encounters. “If you have to be institutionalized and your adult child strongly informs the home that they don’t want you having sex, it’s oddly analogous to parents and teenagers. But the roles are reversed. Middle-aged people don’t like the idea of their parents having a sexual life or getting an STD. It’s a very confusing area for people.” Portmann said. Questions of consent There are more risks than STDs. At what point does age and mental and physical health collide to the point that sex is no longer safe due to an inability to provide consent due to a dementia or Alzheimer’s diagnosis? In 2015, a longtime Iowa legislator and retired farmer was acquitted after being charged with sexual assault for having sex with his wife, who had Alzheimer’s disease and was in a nursing home. That case and others, however, have raised the notion of the ability of a person to consent to sex and the responsibility held by the nursing home to protect patients and report any assaults as mandatory reporters. “Sexual abuse and unwanted sexual activity is a real issue with dementia patients. Enough of it is going on that it is a pretty prevalent problem,” said Minneapolis-based attorney Mark Kosieradzki, who has tried several cases of sexual abuse in nursing homes. State laws vary about the ability to consent. Reingold said memory issues are increasingly a concern in assisted-living programs as people try to age at home as long as possible and tend to go to a residential program needing a much more advanced level of care. “If there’s any doubt in our minds about the ability to consent, we look at the rights to intimacy against the right to prevent unwanted touching and we will err on the side of protecting against unwanted touching every time. We have to,” Reingold said. The best way to protect against unwanted touch is to talk about the idea of sex and aging and air out the topic as much as possible, Kosieradzki said. “I do believe there is a bias. Claims of sexual assault by the elderly are not taken seriously because there isn’t an understanding of older sexual drives or there’s a bias about why would someone have sex with an 88-year-old,” Kosieradzki said. “There’s not an easy solution. It’s not one of those things that you can’t talk about. It should be thought about and discussed frequently as people get older and have different caregivers or live in different residential communities,” Kosieradzki said.