Herzing University Online FNP Perspective Peer Responses

Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

Do you agree with your peers’ assessment?
Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.

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Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Be sure to review your APA errors in your reference list, specifically you have capitalization errors in some words of the titles.Include the DOI. Also, be sure you are italicizing titles of online sources.No more than 200 words maximum.

Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least two of these prompts:

Do you agree with your peers’ assessment?
Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
Share your thoughts on how you support their opinion and explain why.
Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format.

TONISHA’s Response

Older adults may have the desire to continue sexual activity; however, sexual outcomes may be affected by physical, social and psychological changes experienced by both men and women. Although older patients may remain interested in expressing sexuality, sexual activity is often decreased. Contributing factors for decreased sexual activity in men can include “poor health, decreased partner availability, decreased libido, and erectile dysfunction” (Ham, Sloane, Warshaw, Potter & Flaherty, 2014, p 352). For women, “urogenital symptoms, such as difficulty with lubrication, inability to climax, lack of pleasure during sex and pain during intercourse” can contribute to decreased sexual interest (Ham et al., 2014, p 356). In a patient encounter, the patient presented for complaints of a suspected sexually transmitted disease as she had began a new relationship a few months prior and was now experiencing vaginal itching and burning and a foul vaginal discharge. This patient was open to discuss her sexual history and was receptive to patient education for safe sexual practices.

Increases in sexually transmitted diseases have been noted among the geriatric population. This increase may be related to the lack of knowledge of safer sexual practices, decreased condom usage and/or lack of sexual health screening. STDs left untreated can lead to HIV, other infections and worsen comorbidities (Jameson, 2011). Prevention and education are key in reducing STDs and improving safe sexual practices. Prevention strategies such as having only one sexual partner and using condoms consistently and correctly during sexual intercourse should be discussed. The health care provider should also clear up any misconceptions the patinet has about STDs. In addition, the signs and symptoms of sexual transmitted diseases should be reviewed as patients should know when to seek medical treatment.

Ham, R., Sloane, P., Warshaw, G., Potter, J., Flaherty, E. (2014). Ham’s primary care geriatrics: A case-based approach (6th ed.). PA: Elsevier.

Jameson, M. (2011). Seniors’ sex lives are up – and so are STD cases around the country. Retrieved from https://www.aarp.org/health/conditions-treatments/news-05-2011/seniors_sex_lives_are_up_and_so_are_std_cases.html

Sarah’s Reponse

Sex and the Aging Patient

When you think of sex, what age group comes to mind? Despite the common thought of picturing the younger population, elders are still very much sexually active. With increased divorce and widow rates, people in their sixties, seventies and eighties are re-entering the dating and sexual scenes (Weiss, 2014). Now that senior women are postmenopausal, pregnancy is no longer a consequence of unprotected intercourse. With menopause, also comes vaginal dryness that is a frequent complaint of older women. Hormone therapy and lubrication are frequently utilized for these issues. Often times, older men worry about erectile dysfunction. With the rise in medication prevalence for erectile dysfunction, combined with women who can no longer bear children, safe sex practices for seniors are becoming obsolete. Many of today’s “Baby Boomers” came to maturity during the sexual revolution of the 1960s/1970s and are now reverting back to their previous risky sexual behavior, but under different circumstances (McDaniel, 2016).

Situation

I encountered a seventy-nine-year-old female patient who lost her husband of fifty-three years. Two years later, she decided that it was time to date. The patient reported that she had been sexually active with four partners since her husband passed away. The patient went to her gynecologist and requested a pap smear and sexually transmitted disease (STD) testing. The patient’s pap smear results came back positive for Human Papilloma Virus (HPV). Prior to this finding, she had no history of abnormal pap smears or positive HPV results. The patient was embarrassed and admitted that safe sex habits were not practiced because of her inability to conceive and her advanced age, “STDs didn’t even pop into my mind in the moment” she said.

STD Prevalence

The senior citizen population are heavy contributors to the increased prevalence of STDs. When you think of unsafe sex, the image that comes to mind is not necessarily that of senior citizens, but according to the CDC, the rates of STD infection for people over sixty-five years old rivals that of people in their twenties (Redmonde, 2015). For example, among people ages fifty-five to sixty-four, reports of chlamydia cases nearly doubled between 2012 and 2016 (Harvard Health Publishing, 2018). Seniors are contracting STDs at an alarming rate and the range of disease is comparable, if not more profound than in younger generations.

Sequela of Untreated STDs in Elder Patients

As people age, their immune systems tend to weaken, making them more susceptible to contracting diseases, including STDs. In women, untreated chlamydia or gonorrhea can develop into painful pelvic inflammatory disease, which may require treatment with intravenous antibiotics and hospital admission (Harvard Health Publishing, 2018). In men, these diseases can lead to infection of the urethra and pain when urinating. Contracting a STD also increases the risk of human immunodeficiency virus (HIV). Untreated syphilis can lead to complications such as heart damage and dementia as well (Harvard Health Publishing, 2018).

Education

Most of the current senior population was married in the 1980s and 1990s, during a time of increased STD awareness, so they missed out on education about this topic (Dorfman, 2014). In fact, the only members of our current senior population that ever received formal STD education were soldiers, and for them the warnings were only in regard to “ladies of the night” in foreign ports (Weiss, 2014). Education about prevention, symptoms, and treatment options need to be discussed with this population of elders. This includes learning about STDs and how to recognize signs, how they can complicate medical conditions, and most importantly, the significance of safe sex and the proper use of condoms (McDaniel, 2016). The information needs to be made clear that unprotected sex can have serious consequences that threaten health and wellness, while also portraying a message that safe sex is healthy and acceptable. It is all about the tone and content of the message delivery. Being non-confrontational, identifying barriers, setting realistic goals, and taking a motivational approach can prove to be successful when implementing care plans that involve patient behavior changes about sensitive topics such as STD education.

References

Dorfman, S. (2014). Boomer health: Stats say seniors need refresher in sex-ed. Palm Beach Post.

Retrieved from https://www.palmbeachpost.com/lifestyles/health/boomer-health-stats-say-

seniors-need-refresher-sex/u4ph1WMC5bHRzrIBUsSH5I/

Harvard Health Publishing. (2018). Sexually transmitted disease? At my age? Retrieved from

https://www.health.harvard.edu/diseases-and-conditions/sexually-transmitted-disease-at-my-

age

McDaniel, D. Y. (2016). Sex and seniors – STDs a new reality for the elderly [Web log post].

Retrieved from https://www.huffingtonpost.com/derrick-y-mcdaniel/sex-and-

seniors-stds-a-ne_b_9619778.html

Redmonde, A. (2015). Sexually active seniors facing increased risk of STDs. Suncoast News.

Retrieved from http://www.mysuncoast.com/health/sexually-active-seniors-facing-increased-

risk-of-stds/article_e0b4b284-ae26-11e4-b72f-3b65d1ef5ff3.html

Weiss, R. (2014). Baby boomers gone wild! Seniors and STDs. Retrieved from Psychology

Today: https://www.psychologytoday.com/us/blog/love-and-sex-in-the-digital-

age/201403/baby-boomers-gone-wild-seniors-and-stds

Herzing University Online FNP Perspective Peer Responses