Assessment and Conceptualization of Sexuality Among Older Adults

Older adult sexuality is receiving increasing attention in mental health practice and research as societal changes foster greater acceptance of both sexuality and diversity. Older adult men and women face disparate circumstances affecting sexuality, including differences in patterns of sexual desire and activity, hormonal changes, access to partners, and treatment options, including pharmacotherapy. Thorough assessment of older adult sexual functioning includes attention to diversity issues as outlined in the DSM-IV-TR cultural formulation model, with particular attention to clients' multiple identities and to awareness of the impact of one's own cultural beliefs about sexuality. Available assessment tools include semi-structured interviews and self-report scales, some of which are designed for gathering data from both partners in a couple. Mental health practitioners need to advocate for clients' access to sexual expression despite institutional barriers, including at end-of-life.