Wallach Isabelle, Keyser-Verreault Amélie, Beauchamp Julie, Brisson-Guérin Maude, Sussman Tamara, Durivage Patrick
Department of Sexology, Université du Québec à Montréal, Montreal, Quebec, Canada.
Department of Psychiatry and Neurosciences, Université Laval, Quebec City, Quebec, Canada.
Gerontologist. 2023 Feb 25;63(2):318-327. doi: 10.1093/geront/gnac150.
The sexuality of older people, which has historically been invisible, is increasingly represented and promoted in the media. However, the sexuality of the oldest older adults showing signs of frailty remains obscure and subject to ageist and ableist biases. Studies on sexual expression at the end of life have shown that sexuality and the need for support related to it remain important for many people.
This article examines the perceptions and attitudes of professionals regarding the sexuality of older adults in palliative care, based on an exploratory qualitative study. Participants were recruited from several palliative care teams working either in hospital or in home settings in Canada.
Professionals (n = 16) held two main views of sexuality: broad and holistic or narrow and genital-focused. Perceptions of sexuality in later life were either described as a continuation of or distinct from middle adulthood. No matter what views were held, most professionals did not discuss sexuality with their patients at the end of life.
The lack of communication about sexuality may be largely due to professional's ageist, ableist, and heterosexist views regarding the sexuality of this population group. Results confirm the relevance of providing palliative care training about diverse sexual experiences and the importance of supporting older adults at the end of life with respect to their intimate and sexual needs. Such an approach is in line with the holistic vocation of palliative care.
老年人的性取向在历史上一直不为人所见，但在媒体中越来越多地被呈现和宣扬。然而，那些表现出虚弱迹象的高龄老年人的性取向仍然模糊不清，且受到年龄歧视和能力歧视的偏见影响。关于临终时性表达的研究表明，性取向以及与之相关的支持需求对许多人来说仍然很重要。
本文基于一项探索性定性研究，考察了专业人员对姑息治疗中老年人性取向的看法和态度。参与者是从加拿大几家在医院或家庭环境中工作的姑息治疗团队招募而来的。
专业人员（n = 16）对性取向持有两种主要观点：宽泛和整体的观点或狭隘和以生殖器为重点的观点。对晚年性取向的看法要么被描述为中年期的延续，要么与之不同。无论持有何种观点，大多数专业人员在临终时都没有与他们的患者讨论性取向问题。
关于性取向缺乏沟通可能主要是由于专业人员对这一人群的性取向持有年龄歧视、能力歧视和异性恋至上主义的观点。研究结果证实了提供关于多样化性经历的姑息治疗培训的相关性，以及在临终时支持老年人满足其亲密和性需求的重要性。这种方法符合姑息治疗的整体使命。
