Older Road Users: Myths and Realities, A Guide for Medical and Legal Professionals

However, there may be some considerations to take into account before taking up a new exercise regime. Talk to your healthcare team for more information. But there are certain illnesses that are more common in people with diabetes, and diabetes may also alter the course of an illness — for example, a person with diabetes may become more unwell or be unwell for longer than a person without diabetes. Having diabetes should not stop you from getting and keeping a job. However, despite the Equality Act Disability Discrimination Act in Northern Ireland , people with diabetes still face blanket bans in some areas of employment, including the armed forces.

Diabetes UK campaigns to lift discriminatory blanket bans. Many flight socks carry the warning that they are not suitable for people with diabetes. If you have any circulatory problems or complications with your feet, such as ulcers, then speak to your GP before using them.

If, however, your feet and legs are generally healthy and you are normally active, using flight socks is unlikely to do you any harm. People sometimes think that if they have diabetes they can't eat grapes and bananas as they taste sweet. But if you eat a diet that includes these fruits, you can still achieve good blood glucose control. In fact, grapes and bananas, like all fruit, make a very healthy choice. Fruit is high in fibre, low in fat and full of vitamins and minerals.

It helps to protect against heart disease, cancer and certain stomach problems. Read more on the fruit and diabetes myth and watch our video. If you have diabetes you should keep your nails healthy by cutting them to the shape of the end of your toes. Don't cut them straight across, curved down the sides, or too short. Remember, your nails are there to protect your toes.

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It is safest to trim your nails with a pair of nail clippers and to use an emery board to file the corners of your nails. If it is difficult for you to care for your nails, you should seek help from a podiatrist. It is important to realise that there is a lot of misinformation out there. Make sure you get your information from reliable sources, such as your diabetes healthcare team or Diabetes UK. More on taking care of your feet. People with diabetes travel all over the world — you do not need to choose special holidays or curb your wander lust. The key is making the right preparations to minimise any potential problems and have an enjoyable safe trip.

Managing your diabetes can at times seem incredibly demanding and some people find that support and encouragement can be really beneficial in helping them cope. Support should ideally come from someone you have regular contact with, maybe your partner, a friend, or someone from your healthcare team. Ask your healthcare team about any support groups in your area. Reasons given include embarrassment and lack of knowledge or experience. The patients interviewed by the researchers said they would have liked to have been told about the changes in sexual function they could expect and to have opportunities to ask questions [ 28 ].

An Israeli study [ 10 ] examined the reactions of staff in psychogeriatric care homes to sexualised behaviour among their elderly institutionalised patients with dementia. It classified sexualised behaviours into three groups: The staff were accepting and encouraging of behaviour at the level of love and caring. Behaviour at the level of romance evoked mixed reactions including amusement. Behaviour at the level of eroticism evoked strong feelings of anger and disgust among staff. Although the expression of sexuality is a basic human right, many members of staff found it disturbing.

There are of course also issues surrounding consent in patients with dementia and there must be careful consideration to ensure older adults are safeguarded against non-consensual sexual activity. Although it is important to be aware of older people's sexuality, care must be taken not to over-sexualise the ageing process, nor to over-medicalise declining sexual function and interest.

The heavy involvement of drug companies in the definition of female sexual dysfunction as a medical diagnosis is potentially worrying [ 17 ]. They describe how changing attitudes in the s among geriatricians meant that sexual activity began to be seen as a healthy and even necessary part of successful ageing. Some older women feel that there is too much pressure on them from society to remain interested in sex [ 18 ].

HCPs should screen for sexual dysfunction in their older patients [ 30 ], especially those with chronic diseases, on certain medications, or men presenting with lower urinary tract symptoms [ 14 ]. Where appropriate, post-menopausal women should be asked directly about symptoms of urogenital atrophy as the environment of care may not feel appropriate for patients to initiate the conversation even if it is causing significant distress [ 18 ]. It may be helpful to open the conversation by first asking permission to ask more personal questions [ 31 , p.

Questions such as those in Box 1 may offer patients an opportunity to discuss such issues. Patients tend not to feel comfortable discussing topics such as sexuality unless they feel there is adequate time to discuss the issue [ 16 ], and privacy also needs to be considered. Elderly patients often attend with their adult children, and might not be comfortable discussing sexual issues in front of them [ 31 , p.

GPs should recognise that many elderly people would prefer discussing sexual issues with a doctor of the same gender and as close to their age range as possible [ 21 ]; appointments with colleagues should be offered as appropriate. Educating patients is an important task. Patients should also be educated about the changes they can expect in sexual functioning as they age, and the options available to help them [ 31 ].

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HCPs also need to be educated to increase awareness of sexuality in older age and improve communication skills [ 25 , 26 ]. There is a lack of education surrounding the sexual needs of elderly institutionalised people; staff in elderly care homes and psychiatric units should be trained to better appreciate the sexual needs of older people [ 10 ]. There is a need for a change in culture whereby all staff concerned are comfortable with issues of sexuality in the elderly, such that it becomes a basic part of training [ 32 ]. Some research has suggested that home visits for nursing home residents should be facilitated if a sexual partner is available [ 33 ].

At the very least, privacy should be respected where at all possible. HCPs also need to be very aware of and deal with their own emotional reactions and attitudes to the patient the countertransference without letting any prejudices they may have affect patient management [ 31 , pp.

This can be helped by appropriate supervision and a multidisciplinary approach when possible e. Some people on these medications notice sexual problems. Is that something that has affected you at all? Sometimes when people feel very low and depressed they lose all interest in sex. Do you think that is an issue for you?

Often women around the time of the menopause can suffer not only with the hot flushes you have described but also with sexual problems such as vaginal dryness. Is that something you have experienced? These can all be followed up as appropriate by stating that if there are problems identified now or in the future, there are a range of treatments to help. Many older people enjoy an active sex life, although they are likely to experience problems. In general, the environment of care does not lend itself to discussions about sex and many patients find it difficult and embarrassing to talk to HCPs about sexual problems.

Conversely, many HCPs believe that their older patients are not or should not be sexually active. More training is needed for HCPs who work with older people both to impart knowledge of elderly sexuality and the skills required to discuss it sensitively.

In conclusion, sexual problems in older people should be managed sensitively and practically by HCPs, with respect to individual differences in sexual interest and activity. Some older people face sexual problems which they find embarrassing to discuss with healthcare professionals.

Healthcare professionals do not ask older patients about sex even when highly relevant such as in assessing depression. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account.

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Close mobile search navigation Article navigation. Background—are older people even interested in sex? Do they have sex? Problems faced—what causes the decrease in sexual interest and function in older adults? A word of caution…. Recommendations—how can HCPs help improve the sex lives of older people? Sexuality in older age: Office for National Statistics. National service framework for older people, May accessed 10 June Better prevention, better services, better sexual health—the national strategy for sexual health and HIV, July accessed 10 June Sexual behavior and sexual dysfunctions after age Sexual desire, erection, orgasm and ejaculatory functions and their importance to elderly Swedish men: Sex, health, and years of sexually active life gained due to good health: Contradictions in the medical encounter: The day to day impact of urogenital aging: Love and sex after Under-reporting of erectile dysfunction among men with unrelated urologic conditions.

Barriers to seeking treatment for sexual problems in primary care: Sexuality and the satisfaction of sexual needs: General practitioner attitudes to discussing sexual health issues with older people. GP and practice nurse barriers to talking about sexual health in primary care. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. Sexual behaviour of nursing home residents: Sexual interest, activity, and satisfaction among male nursing home residents.

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