A woman, age 72, with a total hip replacement and arthritis who is interested in continuing sex with her partner. (100 words minimum)

Chapter 13
Sexuality and Aging

Objectives (1 of 3)

Recognize the importance of intimacy in feelings of sexuality.

Differentiate between sex and gender.

Define sexuality.

Recognize complications from common diseases that can interfere with the expression of sexuality.

Objectives (2 of 3)

List techniques to ameliorate complications in the expression of sexuality.

Identify some approaches to deal with sexuality issues, including the PLISSIT model.

Recognize the role prescription drugs can play in sexual expression.

Understand the causes of inappropriate client/patient sexual behavior and be able to choose appropriate responses.

Objectives (3 of 3)

Describe gender differences, including those in lesbian, homosexual and transgender persons, in sexual functioning caused by aging.

Recognize the ethical and policy dilemmas for sexuality for institutionalized older adults.

Sex & Sexuality (1 of 26)

  • Sexual innuendo pervades our society
  • Little time or attention devoted understanding our sexuality
  • Exploring our sexuality
  • Lifelong process
  • Frames how we see ourselves
  • Can greatly influence how we act

Sex & Sexuality (2 of 26)

  • Circles of Sexuality model
  • Ring of overlapping circles that represent the five core components of sexuality:
  • Sensuality
  • Intimacy
  • Sexual identity
  • Sexual health
  • Reproduction and sexualization

Sex & Sexuality (3 of 26)

  • FORGE
  • National transgender anti-violence organization
  • Added “power” to the sexualization circle to address issues of power and control often experienced by the LGBTQ community

Sex & Sexuality (4 of 26)

  • Similar models suggest sexuality is influenced by:
  • Feelings and beliefs about what it means to be male or female
  • Relationship(s) with people of similar or other genders
  • How relationships are established
  • How feelings are expressed

Sex & Sexuality (5 of 26)

  • Family, culture, and religious environments influence the development of sexuality
  • Being loved and nurtured fosters and strengthens our sense of competence
  • Abuse can inhibit the development of a positive sense of self-worth

Sex & Sexuality (6 of 26)

  • Sexuality is also influenced by:
  • Our self-perception as sexual beings
  • How our first expressions of overt sexual feelings were received by others

Sex & Sexuality (7 of 26)

  • Aging and sexuality
  • Sexual identity does not disappear with aging
  • Sexual feelings and urges simply change
  • Older adults may have fewer sexual encounters, but may find more pleasure by linking sex and intimacy to quality of life
  • Pleasuring, cuddling, and touching have been found to be more important among older adults

Sex & Sexuality (8 of 26)

  • Lindau study on sexuality among older adults found:
  • The two people involved define the parameters of the sexual relationship
  • An infinite variety of possibilities may prove satisfying to one or both partners
  • Main challenge for women remains finding a partner with whom to be intimate

Sex & Sexuality (9 of 26)

  • Another study identified a strong association between physical health and sexual activity among older adults
  • Identified benefits of mutually agreeable sex:
  • Improved health
  • Increased life span
  • More solid relationships
  • Bona fide escape from reality

Sex & Sexuality (10 of 26)

  • Study participants reporting some sexual problems indicated:
  • Sexual activity only began to substantially decrease after the age of 74
  • Problems experienced included:
  • Erectile dysfunction for men
  • Low libido, vaginal lubrication, and climax difficulties for women

Sex & Sexuality (11 of 26)

  • Findings from an analysis of the 2005–2006 National Social Life, Health, and Aging Project:
  • Sexual problems occurred in response to multiple stressors, not biological aging
  • Sexual health was directly affected by the strength and quality of the intimate relationship

Sex & Sexuality (12 of 26)

  • British study by Gott and Hinchliff found:
  • Older adults identified sex as an important part of a close relationship
  • Health problems and widowhood often led to a reprioritization of the role of sex
  • Intercourse remained centrally important even when viewed as no longer possible

Sex & Sexuality (13 of 26)

  • Study of older adults with lower socioeconomic status found:
  • Participants wanted to engage in sexual activities more frequently than they did, but lacked a partner
  • Touching and kissing were most desired
  • Mutual stroking, masturbation, and intercourse were less desired and infrequently experienced

Sex & Sexuality (14 of 26)

  • Intimacy
  • Requires self-acceptance and risk taking
  • Reinforces feelings of self-esteem and trust
  • Important component of meaningful sexuality
  • Reconciling the differences between one’s masculine and feminine qualities may be a key to vital aging
  • Embracing gender changes can enhance sexual activity

Sex & Sexuality (15 of 26)

  • Physiologic changes in sexual functioning
  • Women
  • Physical changes do not need to preclude sexual activity
  • Reduced sexual hormones only affect response time and intensity of physical response
  • Knowledge and appropriate adaptations can enhance sexual satisfaction in late life

Sex & Sexuality (16 of 26)

  • Menopause
  • Physiologic marker for changes in sexual functioning
  • Medicalization has identified female sexual dysfunction as a new category of disease
  • Culture, religion, family experiences, and level of acceptance of the aging process impact how a woman approaches and manages menopause

Sex & Sexuality (17 of 26)

  • Estrogen replacement therapy (ERT)
  • Recommended to treat “deficiency disease” of menopause
  • Helps alleviate symptoms, but increases risk for conditions such as heart disease, breast and uterine cancer, stroke, and cognitive decline
  • Final decision must be made by the individual considering her own circumstances

Sex & Sexuality (18 of 26)

  • Older women continue to regularly engage in and enjoy sex
  • Can be affected by decreased hormone levels and coexisting medical and psychiatric illnesses
  • Studies have found:
  • Sexually active women report frequent arousal, lubrication, and orgasm into old age
  • Sexual activity was not necessary to attain sexual satisfaction

Sex & Sexuality (19 of 26)

  • Effects of decreased estrogen from menopause:
  • Vaginal changes
  • Vasomotor changes leading to hot flashes or flushes
  • Less rapid and extreme vascular responses to sexual arousal
  • Orgasm with fewer contractions

Sex & Sexuality (20 of 26)

  • Effects of decreased estrogen from menopause (continued):
  • Bladder and urethral changes
  • Diminished fatty tissue of mons
  • Increased susceptibility of clitoral area to irritation by forced manipulation

Sex & Sexuality (21 of 26)

  • Decrease in libido
  • Sexual desire and activity are not necessarily related
  • Women may participate in sexual activity primarily for intimacy
  • Libido may increase post-menopause
  • Decreased desire may be the result of health problems, medication, or lack of partners

Sex & Sexuality (22 of 26)

  • Men
  • Changes in sexual functioning are less dramatic
  • Physical changes are largely due to reduced circulating testosterone
  • Arousal is delayed with less firm erection and less clear sense of impending orgasm
  • Orgasms may involve abbreviated ejaculation, decreased urethral contractions, decreased force and amount of ejaculate

Sex & Sexuality (23 of 26)

  • Other changes in sexual functioning:
  • Rapid loss of erection postorgasm
  • Longer time needed between erections
  • Decreased swelling and erection of nipples
  • Absence of flush
  • Reduced elevation of testicles
  • Knowing about and accepting these changes can contribute to increased sexual pleasure

Sex & Sexuality (24 of 26)

  • Gender differences
  • Meaning of sexuality can change with age
  • Cultural changes for women may include:
  • Different sexual scripts
  • Engagement in role transitions
  • Increased self-esteem
  • Promotion of their own sexual agency

Sex & Sexuality (25 of 26)

  • Masturbation
  • Safe way to relieve sexual tension
  • Continues through life
  • May enhance feelings of autonomy
  • Viewed by many as a substitute sexual activity

Sex & Sexuality (26 of 26)

  • Study findings indicate that:
  • Many men remain sexually active into their 70s
  • Most women are not sexually active, primarily due to a lack of partners or a decreased libido in their current male partner

Raising the Subject of Sexual Functioning (1 of 4)

  • Sexual functioning and sexuality need to be included as part of functional evaluations across the life span
  • Time and practice are needed to normalize the conversation about sexual functioning
  • Recognize your own discomfort
  • Start engaging patients
  • Ask open-ended questions

Raising the Subject of Sexual Functioning (2 of 4)

  • Practitioners should demonstrate:
  • Sensitivity
  • Empathy and understanding
  • Knowledge of physiologic changes
  • Cultural competency and respect
  • Familiarity with potential intervention strategies
  • Knowledge of available referral resources

Raising the Subject of Sexual Functioning (3 of 4)

  • Common misconceptions:
  • Client will initiate discussion about sexual functioning if it is important
  • Client’s sexual preference aligns with practitioner’s views of sexuality
  • Client is monogamous
  • Client share’s practitioner’s views on morality
  • Client’s age explicitly correlates with libido

Raising the Subject of Sexual Functioning (4 of 4)

  • Discussing sexual functioning with older adults can provide them with many benefits
  • Feeling empowered and less alone
  • Decreased inhibitions
  • Accepting their physical changes
  • Increased comfort with their sexuality
  • Enhanced sexual responses
  • Better communication

Assessing and Addressing Sexual Functioning (1 of 15)

  • PLISSIT model
  • Helps practitioner identify the level of intervention needed
  • Assists practitioner in understanding the level at which he or she can provide the intervention
  • Each ascending level requires more expertise from practitioners than the previous level
  • Knowledge of available resources is necessary

Assessing and Addressing Sexual Functioning (2 of 15)

  • Levels of treatment in the PLISSIT model
  • Permission
  • Limited information

Comprehensive Plan for Alumni and Community Collaboration

Comprehensive Plan   for Alumni and Community Collaboration

The school exists to serve the community more than the community to serve the school. However, a mutually collaborative relationship has significant benefits to both school and community. Harnessing the support of alumni residing locally can lend significant support to this relationship. In this assignment, you will consider methods to harness the support of alumni in the creation of a mutually collaborative relationship with the community. For this assignment, the learner will continue working with the Collaborative Planning and Diagnostic Instrument included in the Rubin textbook. The learner will use the information gathered in phases 1-5 and develop a comprehensive plan for cultivating and maintaining a collaborative environment for a K-12 institution and community.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Refer to the Collaborative Planning and Diagnostic Instrument discussed in Resource 1 Planning and Assessment in the Rubin textbook.

· This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included.

· You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Directions:

Write a paper (1,250–1,500 words) in which you consider the application of the Collaborative Planning and Diagnostic Instrument offered in the Rubin textbook to the creation of a mutually collaborative relationship with the community. Include the following in your paper:

1. A research-supported discussion of how phases 6-14 could be applied to creating a mutually collaborative relationship with the community.

2. A research-based discussion of how alumni could be engaged to support the application of phases 6-14 as described above.

Are Families Dangerous Essay

Please read the essay below and respond to the following question with a 1-2  page MLA essay containing at least one quote from “Are Families Dangerous?” Please organize your essay into paragraphs and be sure that it is proofread before submitting. In developing your essay be sure to use specific arguments and illustrations, which you may draw from your personal experience, the experiences of others, and any of your reading.  Question: What reasons does Ehrenreich provide to convince her audience that families are dangerous? How persuasive do you find her assertions and examples?  You may submit your essay either as a text entry or a file upload.

INTRODUCTORY NOTE: Barbara Ehrenreich is a widely-published political essayist and social critic. She is the author or co-author of 12 books. She published the essay reprinted here originally in Time magazine under the title “Oh, Those Family Values.” See attached Article for reading and referencing.  No

ARE FAMILIES DANGEROUS?

A disturbing subtext runs through our recent media fixations. Parents abuse sons—allegedly at least, in the Menendez case—who in turn rise up and kill them. A husband torments a wife, who retaliates with a kitchen knife. Love turns into obsession, between the Simpsons anyway, and then perhaps into murderous rage: the family, in other words, becomes personal hell.

This accounts for at least part of our fascination with the Bobbitts and the Simpsons and the rest of them. We live in a culture that fetishes the family as the ideal unit of human community, the perfect container for our lusts and loves. Politicians of both parties are aggressively “pro-family,” even abortion-rights bumper stickers proudly link “pro-family” and “pro-choice.” Only with the occasional celebrity crime do we allow ourselves to think the nearly unthinkable; that the family may not be the ideal and perfect living arrangement after all—that it can be a nest of pathology and a cradle of gruesome violence.

But consider the matter of wife battery. We managed to dodge it in the Bobbitt case and downplay it as a force in Tonya Harding’s life. Thanks to O.J., though, we’re caught up in a mass consciousness-raising session, grimly absorbing the fact that in some areas domestic violence sends as many women to emergency rooms as any other form of illness, injury or assault.

Still, we shrink from the obvious inference: for a woman, home is, statistically speaking, the most dangerous place to be. Her worst enemies and potential killers are not strangers but lovers, husbands and those who claimed to love her once. Similarly, for every child like Polly Klaas who is killed by a deranged criminal on parole, dozens are abused and murdered by their own relatives. Home is all too often where the small and weak fear to lie down and shut their eyes.

At some deep, queasy, Freudian level, we all know this. Even in the ostensibly “functional,” nonviolent family, where no one is killed or maimed, feelings are routinely bruised and often twisted out of shape. There is the slap or put-down that violates a child’s shaky sense of self, the cold, distracted stare that drives a spouse to tears, the little digs and rivalries. At best, the family teaches the finest things human beings can learn from one another—generosity and love. But it is also, all too often, where we learn nasty things like hate and rage and shame.

Americans act out their ambivalence about the family without ever owning up to it. Millions adhere to creeds that are militantly “pro-family.” But at the same time millions flock to therapy groups that offer to heal the “inner child” from damage inflicted by family life. Legions of women band together to revive the self-esteem they lost in supposedly loving relationships and to learn to love a little less. We are all, it is often said, “in recovery.” And from what? Our families, in most cases.

There is a long and honorable tradition of “anti-family” thought. The French philosopher Charles Fourier taught that the family was a barrier to human progress; early feminists saw a degrading parallel between marriage and prostitution. More recently, the renowned British anthropologist Edmund Leach stated that “far from being the basis of the good society, the family, with its narrow privacy and tawdry secrets, is the source of all discontents.” Communes proved harder to sustain than plain old couples, and the conservatism of the 80’s crushed the last vestiges of lifestyle experimentation. Today even gays and lesbians are eager to get married and take up family life. Feminists have learned to couch their concerns as “family issues,” and public figures would sooner advocate free cocaine on demand than criticize the family. Hence our unseemly interest in O.J. and Erik, Lyle and Lorena: they allow us, however gingerly, to break the silence on the hellish side of family life.

But the discussion needs to become a lot more open and forthright. We may be stuck with the family—at least until someone invents a sustainable alternative—but the family, with its deep, impacted tensions and longings, can hardly be expected to be the moral foundation of everything else. In fact, many families could use a lot more outside interference in the form of counseling and policing, and some are so dangerously dysfunctional that they ought to be encouraged to disband right away. Even healthy families need outside sources of moral guidance to keep the internal tensions from imploding—and this means, at the very least, a public philosophy of gender equality and concern for child welfare. When, instead, the larger culture aggrandizes wife beaters, degrades women or nods approvingly at child slappers, the family gets a little more dangerous for everyone, and so, inevitably, does the larger world.

Previous Next

Difference Between Coaching And Mentoring

Complete Parts 1-3 below as preparation for developing your coaching plan. Approach each part as a way to help the principal at your school understand the differences between coaching and mentoring, as well as consider important questions related to the coaching plan.

Part 1:

Create a chart, diagram, or other visual display of the characteristics, roles, and responsibilities of coaching and mentoring. Highlight the similarities and differences between the two.

Part 2:

Prepare a handout, brochure, poster, or other job aid that you can share with the principal and teachers on your campus that addresses the following questions:

  1. What factors must you keep in mind when working alongside a new principal?
  2. What questions must you ask before determining a new coaching model or program?
  3. What are the strengths of the staff and how can these strengths be utilized in your coaching plan?
  4. In what areas will teachers need the most support? How will you determine these areas of need?
  5. How should goals for student learning be determined? How should those goals be addressed?

Part 3:

Develop a list of five questions to ask the principal as you develop your coaching plan. Provide a rationale for each question and an explanation of how the principal’s responses will help guide you in developing an effective coaching plan.