Lichtenberg Peter A
Institute of Gerontology, Wayne State University, Detroit, MI, USA.
Occup Ther Health Care. 2014 Jan;28(1):42-50. doi: 10.3109/07380577.2013.865858.
Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long-term care settings. Because older adults in medical rehabilitation and long-term care beds present with significant frailties, and often significant neurocognitive disorders, it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literature on sexuality and aging, examines some of the clinical practices and guidelines regarding sexual expression in long-term care, and presents two case examples. A semistructured interview and decision tree is presented to assist therapists in making careful and informed decisions and thereby balancing the needs for protection with the needs for autonomy.
老年人的性取向和性需求仍然是临床干预中一个被忽视的领域，在长期护理环境中尤其如此。由于接受医疗康复和长期护理的老年人存在明显的身体虚弱，且常常伴有严重的神经认知障碍，这使得职业治疗师和其他工作人员很难评估老年居民参与性关系的能力。本文回顾了当前关于性取向与衰老的文献，研究了一些关于长期护理中性表达的临床实践和指南，并给出了两个案例。文中还介绍了一个半结构化访谈和决策树，以帮助治疗师做出谨慎且明智的决定，从而在保护需求和自主需求之间取得平衡。
