1. OUR LATER YEARS
CHAPTER
Aspects of aging that affect our…
Health
S o c i a l E m ot i o n a l We l l b e i n g
Re p r o d u c t i v e H e a l t h a n d S e x u a l i t y
“Our we as old as we look or as old
as we feel”

2. QUESTIONS FOR THOUGHT???
1. How can we make the adaption needed to
maximize good health and maintain Independence
and Quality of Life?
2. How much medical intervention are we
comfortable with in our later years? (60 -80 yrs.)
Breast Exams
Vaginal Exams
Preventative Health
3. How does sex and sexual pleasures fit into our
lives in our later years?

3. THE NEW OLD AGE
Aging has become feminized
Women live longer
Fitness becomes a problem as we
age
65 and older
12% live in poverty
Our bodies in context
Most cultures value and honor older
people
*In the United States they idealize the young and discriminate
against older adults.

4. ADVERTISEMENTS
Advertisements play on and exaggerate a women’s fear and
anxieties about the natural changes in their body as they age
Pharmaceutical – Hormone
replacement & cologin
Plastic Surgery – Botox & Laser
Treatment
Cosmetics – Oil of Olay & Clinique
“ Self acceptance as we age can be hard won but…invaluable” pg
550

5. RELATIONSHIPS
Maintaining Connections
Set new goals as relationships change
Evaluate or assess our love and
relationships
Change in gestational hierarchy in
family
No matter how we define relationships, social connections have
positive effect on ones health
Dealing with Loss
During our older years we experience
the death of more friends and
loved ones

6. GOING AT IT ALONE
65 and older – 42% of women are widowed
65 and older – 14% of men are widowed
65 and older – 45% of women live alone
65 and older – 19% of men live alone

7. AGING AND HEALTH
We all age dif ferently
some women have developed disabilities from
an early age
More women develop disabilities in midlife or
older

8. PREVENTIVE MEASURES: TAKING CARE OF
OURSELVES
The key word is prevention
Prevention is doing what we can to take care of ourselves so as
to avoid or ease the chronic conditions associated with later life
Healthy habits include no nicotine and excessive alcohol and as
much exercise and nutritious eating as possible.

9. PREVENTIVE MEASURES: TAKING CARE OF
OURSELVES CONTINUED
There are many factors beyond our control
such as…
Occupational Health Hazard
High Blood Pressure
Diabetes
Ethnicity
“Strive to make changes that are within out
power”

10. BASIC PREVENTATIVE MEASURES
Start and or continue to exercise
Engage your mind
Get to bed – you need sleep just like young adults
Schedule checkups which can now be paid for by the 2010
health care reform act

11. COMMON CHRONIC DISEASES
Hearth Disease
Osteoporosis
Diabetes
Arthritis
Forms of Cancer
Urinary incontinence… everyone’s favorite topic
You can visit www.cdc.gov/chronicdisease for more
information about chronic diseases

12. GUIDELINES FOR SEXUAL AND
REPRODUCTIVE HEALTH CARE
By the age of 60 a women has undergone regular screenings for
Cervical Cancer
or
Breast Cancer
Longevity is a recent phenomenon in women
so…
There is not a lot of data on screening for women over 85. It is
important to maintain
Vaginal Health
Mamograms – every year for women age 50 -74
Pap screenings – 65 and older should discuss with
their health care provider
Bone screenings should be done at 65 and every 2
years following

13. SEXUALIT Y
The Sex Continuum
Our society views older women as “drugged up”
and sexless.
Sexuality unlike, fertility, can continue throughout your life
Many women enjoy sex more in the middle and later stages of
their lives due to appreciating their body and sexuality more
fully
Adjustments, disruptions or feeling less sexual can also result
from chronic or acute illness or surgery

14. PHYSICAL CHANGES THAT AFFECT SEXUALIT Y
2 01 0 H a r v a r d M e d i c a l S c h o o l S p e c i a l H e a l t h Re p o r t S ex u a l i t y i n M i d l i fe a n d
B eyo n d
Po s s i b l e A g e Re l a te d S ex u a l C h a n g e s f o r Wo m e n :
P hy s i c a l C h a n g e s : Low estrogen
Decreased blood flow to
genitals
Thinning of vaginal lining
Muscle tone
Desire – Decreased libido, fewer sexual
thoughts
Arousal – Reduced vaginal lubricants, less
blood and congestion
Orgasm – Delayed or absent
Resolution – body returns rapidly to a non -
aroused state
“Only 22% of women discuss sex with a physician af ter 50”

15. PRACTICAL APPROACH TO AGE RELATED
SEXUAL CHANGES
Declining Health
Body Changes
Chronic Illness
Medication
Health Benefits to Sexual Activity
Expand Energy
Burns Calories – Brain release endorphins
Reduced Stress
Sleep Better
Delay or minimize incontinence by working pelvis
Delay Pain – Orgasm can reduce pain

16. LOSS OF DESIRE
Women experience a shift in levels of desire throughout their
lives
Reasons for less sexual desire include:
Overwork and anxiety
Loss of newness
Abuse
Gradual changes/accommodations
Not being attracted

17. PLEASURING OTHERS AND YOURSELF
Viagra and other erectile dysfunction medications exist for men
Navigating Health Care
In the twenty -first century medical care there is a great
shortage of doctors, nurses, psychologists, psychiatrists,
dentists and other health care professionals trained in caring
for older adults

18. THE INSTITUTE OF MEDICINE
Predictions in the near future…
2007 = 1 geriatrician for every 2,546 older adults
2030 = 1 geriatrician for every 4,254 older adults
2007 = 1 geriatric psychiatrist for every 11,372 older
adults
2030 = 1 geriatric psychiatrist for every 20,195 older
adults

19. WRONG DIAGNOSIS, WRONG TREATMENT
Providers without adequate training may treat older women
inaccurately
They may not fully treat chronic illness
Misdiagnosis or fail to manage reversible
conditions
Over proscribe medications
People over the age of 65 take 34% of
medications
Prescriptions are based on a yearly basis
in the US
They are only 13% of the US population

20. PLANNING AHEAD
Be proactive … Plan Ahead
Look into retirement
Health Care
Long-term Care
Housing
Activities
Your Community Can Help

21. PLANNING AHEAD CONTINUED
Retirement and Social Security
Planning ahead is critical in dealing with gaps in your earning
during employment years
Raising children
Taking care of older parents
Housing
As you get older you may…
Move to a smaller home
Get a roommate
Moving to a retirement home
Receive elder services in your own house

22. MORE PLANNING AHEAD
Household help and Long Term Care
Long term care services are very expensive
Community Living Assistance Services and Support Act (Class
Act) 2010 Health Reform Law
Voluntary Long-Term Care insurance
program for senior and disabled people to
pay no medical services and support
Contribute for 5 years – A benefit on
average of $50 a day

23. HEALTH AND LEGAL DECISION
Power of Attorney – A trusting person has the authority to act on
your behalf in financial and legal matters if unable to take
action yourself
Health Care Proxy Document – A person you trust authority to
make medical testing and treatment decisions
Medical Advance Directive or Living Will – Describes the medical
treatment one wishes to receive or refuse… and under what
conditions

24. END OF LIFE CARE
Sometimes medical science, not the concern of a women’s life
quality, shapes the advice we receive about death and dying
Talk to a health care provider about your wishes
You need to manage your own healthcare
Compassionate end-of-life care that addresses you emotional,
spiritual and practical needs is essential, regardless of the type
of treatment or care chosen

25. CAREGIVER
66% of caregivers are women
41% work full time
13% work part time
The economic value of caregivers unpaid contributions
is estimated at $375 billion
Care givers have high rates of
Depression
Chronic Diseases
Infections
Exhaustion
This is compared to non-caregivers of the same age

26. RESPITE AND RESOURCES
Family Caregiver Alliance ( caregive.org)
Information services and advocacy for caregivers
National Alliance for Caregivers ( caregiving.org)
Non-profit coalition of national organizations
focused as family caregivers
Roselynn Carter Institute of Caregiving ( roselynncarter.org)
Established local and state partnerships that
build quality long-term and home based services
Share the Care (sharethecare.org)
creative models in which neighborhoods help
families

27. ACCEPTING CARE WHEN WE NEED IT
Women need to accept help without feeling deminished
Helpers need to provide choices when possible
Living Full: Building Community, Continuing Advocacy
“From the bottom of my heart: Life gets greater and more
surprising after 40, 50, 60 and yes 70.”
-Gloria Steinem-
One must have a sense of purpose and enthusiasm for life

28. ACCEPTING CARE WHEN WE NEED IT
CONTINUED
You need fulfillment during later years
Why do you need fulfillment…
Less time left
Clarified priorities
More knowledge of what matters
Dr. Gene Cohen, geriatric psychiatrist was convinced older
people have untapped wells of creativity and skills
“Chocolate for the aging brain”

29. INTERGENERATIONAL LIVING
Older women’s wisdom and skills are much needed by younger
generations
We must work toward building a society that celebrates and
supports the elderly

30. WORKING TOGETHER TO CREATE CHANGE
Older women need to build on the strength they have in numbers
by creating and supporting programs that meet older women’s
needs
Such as…
Long-Term Care
Health Care
Work-Family Balance
Retirement security
Everyone will age
Women need to continue to tell their stories of being mothers,
sisters, daughters, caregivers, workers and push their local, state
and national governments to provide services for their older years!