Substance Abuse, Self-Esteem, and Sexuality in Seniors
Substance Abuse Disorders in Seniors
In the current senior population, substance abuse, particularly alcohol, is a significant concern. Home consumption can be easily overlooked, especially in elderly individuals residing in institutions and hospitals. The metabolism of alcohol slows with age due to liver changes, making diagnosis challenging as socio-isolation can mask addiction.
Medical Complications
Malnutrition and vitamin deficiencies, common in aging, are exacerbated by alcohol abuse. Senile tremors and convulsions become more frequent, and the prognosis for diabetics worsens. Alcoholic neuropathy is also more prevalent, and the risk of dementia increases.
Treatment of Alcoholism
Age should not be a barrier to alcoholism treatment. Pharmacological interventions should be administered at lower doses. Hospitalization for detoxification is generally not recommended. Psychological therapies are as effective in older adults as in other age groups.
Lower Self-Esteem in Seniors
Lower self-esteem is a state where an individual experiences a negative self-evaluation regarding their capabilities. This can be triggered by:
- Changes in body image (associated with aging)
- Losses (of loved ones, physical functions, economic stability)
- Increased dependence and a diminished sense of control
Manifestations
- Negative self-perception: feelings of inferiority, failure, guilt, and uselessness.
- Seclusion, hypersensitivity to criticism, and excessive dependence on others in social interactions.
- Underlying disease, disability, or abuse.
- Seeking excessive recognition.
Criteria
Expressed feelings.
Expected Outcomes
- Positive feelings about oneself and one’s capabilities.
- Ability to describe the causes of negative feelings.
- Realistic assessment of one’s capabilities compared to others of the same age.
- Understanding how to utilize positive qualities.
Nursing Interventions
- Promote positive views of individuals.
- Foster positive social attitudes.
- Address environmental problems arising from health alterations.
- Increase social interactions.
- Develop personal independence.
- Evaluate the inclusion of self-help groups or psychotherapy.
- Maintain a daily record of mood and its relationship to activities.
- Design a plan for pleasant activities and gradually reduce unpleasant ones.
Session 1
Monitor mood fluctuations in the elderly. Document them. Identify and record adverse and pleasant events of the day.
Session 2
Identify a problem and an object of exchange, encouraging the elderly to choose achievable objectives.
Sexual Response in Aging
As individuals age, they may experience a decrease in enjoyable social events and begin to disengage from leisure activities, leading to increased monotony. Pleasure may rely more on imagination than physiology. With age, one must adapt to the physiology of imagination. Sexuality persists as long as imagination does, but the need for demonstrations of affection remains.
An individual’s sexual interest evolves through different stages: courtship, established partnership, stability, separation, and widowhood, requiring personal coping strategies.
Real Problems
- Fatigue and boredom with established sexual routines.
- Lack of opportunity to meet new partners.
- Gender imbalance in the older population.
Myths
- Sex is not important in the elderly.
- Older adults should be asexual.
- It is more acceptable for older men to pursue sex with younger women than vice versa.