The Elephant in the Room

Montrose Daily Press [June 5, 2015] Kathryn R. Burke

(Senior Sex-Ed)  Even if you’re in good health, after a certain age, talking about sex can be uncomfortable. If your doctor asks, “Do you?” or “How often?” you are likely to squirm, maybe duck the question, and mumble a noncommittal answer (women) or brag about sexual prowess (men, even with a missing prostate).

Older people do have sex—they really do! And most of the time, they manage just fine. Many nursing homes accommodate conjugal visits. Regardless of where ‘home’ is, though, what happens when desire dims, when illness or injury diminishes sexual performance, or in some cases, catapults into insatiability? What do you do when physical intimacy is no longer possible or when one partner wants it and the other doesn’t?

Jerry is a retired social worker and counselor, a compassionate, gentle soul whose career entailed helping people. Sara, his wife of 50 years, is a retired high school teacher. Both are well known and respected in the community. A few years ago, Jerry began to lose things and forget people and places. Dementia took a bizarre twist as Jerry became inappropriately affectionate to Sara—the kids remarked on it: lots of touching, squeezing, rubbing, and body contact. Sara wrote it off as Jerry feeling lost and unappreciated after retirement. Before long, though, Jerry was pawing Sara in public and making physical demands in private that were painful to a post-menopausal woman. Not sure how to handle Jerry’s escalating sexual needs, and embarrassed to talk about it, Sara finally confided in her daughter, who suggested she talk with her doctor—and Jerry’s.

Jerry’s doctor calmed his overactive libido with pharmaceuticals. He advocated strenuous exercise to mitigate sexual energy. Sara’s doctor suggested couples’ counseling. It all helps. No more public pawing! They still have sex, but not too often. Although Jerry’s cognitive capacity is failing, and he now is uncomfortable where there are ‘too many people,’ he and Sara are discovering ‘togetherness’ alternatives as their world shrinks. They take a scenic ride (Sara does the driving now) with a lunch stop. They walk in the park, holding hands. Sometimes they just stay in and watch a movie, snuggling on the sofa and sharing a bucket of popcorn.

JoAnne never really liked ‘sexual intercourse,’ as she termed it, so when Carl became impotent, she was secretly relieved. JoAnne was a ‘stare at the ceiling and hope it’s over soon’ kind of gal. Over the years, Carl may have suspected her lack of enthusiasm, but they never really discussed it. Then, Carl had a cardiac event followed by surgery and medication. The sex boat had sailed, and it wasn’t likely to drop anchor again. JoAnne was elated; she could stop pretending. Carl was devastated; he felt emasculated. Frustrated, he finally confided in his cardiac support group. Their advice was to seek counseling—for both of them.

They did, and the counselor referred them to a specialist who suggested they experiment with alternative forms of sexual stimulation. JoAnne refused to go after one session. Still reticent to talk about the problem, JoAnne did agree to see a therapist. She realized that because of a long-ago traumatic incident, she didn’t enjoy sex and probably never would. JoAnne also recognized that she resented having to be ‘mommy’ instead of ‘wife.’ Carl had always been the ‘strong’ one; now she was taking care of him instead of the other way around. Their new situation prompted honest and meaningful conversation—something they had forgotten how to do. Once JoAnne managed let go of the resentment (most of the time), and Carl dialed back on despair from not being able to have sex, they could talk about how to maintain a positive relationship without sexual intimacy. Hugs help. Both love history and travel. They’re headed off now on an educational National Geographic expedition. They are having fun, and genuinely enjoying one another—maybe for the first time in years!

Sex may be the elephant in the room, but it doesn’t have to be so big after all. When physical intimacy poses problems (can, can’t, don’t want to), talking it out will open the door to a new and improved relationship.

Kathryn R Burke is the author of The Caregiver’s Journey, Navigating the Path and The Caregiver’s Journey, Building Your Care Team. Both books are available at, which also lists current speaking engagements and book signings.