Pangman and Seguire Journal Review "Sexuality and the Chronically Ill Older Adult:

A Social Justice Issue"

"Sexuality and the Chronically Ill Older Adult: A Social Justice Issue" is an article by Verna C. Pangman and Marilyn Seguire, first published in 2000 in Volume 18 of the journal Sexuality and Disability. In their article, Pangman and Seguire provide a penetrating look at an issue all too often obscured by either false assumptions of unimportance, or perhaps mere squeamishness. The subtitle of their article makes it clear that Pangman and Seguire are approaching this issue from a political (if not indeed activist) standpoint: they seem particularly concerned that there is a sense of invisibility to the sex problems of the elderly, and a willingness to ignore those problems. They offer nurses a way of thinking about these issues.

Summary of Article

Pangman and Seguire begin by brushing away some of the myths and rumors that still cling like cobwebs to the subject of sexuality and the elderly -- notions that the elderly are sexless or undesirable, based on the strong association of sexuality with youth in western society. They offer a definition of sexuality and sexual health in which the life-affirming aspects of the sex act, and conceive of "sexual health care" as being "an essential component of overall wellness during one's developmental lifespan" (49). They offer a cursory discussion of "invisibility and visibility perspectives" of the sexuality of the elderly and chronically ill, sketching some stereotyped views that are lingeringly held by some sectors of society and even among health care professionals. Pangman and Seguire are explicit in offering a "social justice" perspective in which the mere awareness of these issues among nurses can "[raise] the level of consciousness" and "help to dispel the myth that aging renders the chronically ill older adult sexless and worthless" (50).

The authors approach the issue with a willingness to acknowledge that...

This is what they refer to as the "invisibility" of sexuality among the elderly and chronically ill: it is not an issue that forms the subject of glamorous Hollywood movies, and is hampered in public discussion by a sort of "ick factor" which causes people to skirt the issue or deny its importance. The authors propose to counteract this "invisibility" by increased visibility.
By visibility, the authors mean that changing sexual mores have ensured greater public discussion, awareness, and comfort with sexuality, including the sexuality of the elderly. They note a seeming shift in public opinion on these matters, which is surely do to the aging population of Baby Boomers who participated in the Sixties and the "Summer of Love" but who are now themselves in their sixties, and looking forward to a long twilight in which their sheer numerical bulk ensures that attitudes towards sexual issues in elder care must reflect all sectors of the patient population. The authors think this visibility is important and that nurses ought to validate it, because "by allowing them credence to their sexual expression, the older adults who are chronically ill are able to claim a sense of self-identity, respect, and dignity in society" (53).

The remainder of the paper consists in Pangman and Seguire relating their subject to the nursing profession, and exploring how an awareness of the sexual needs and sexual-identity-related quality-of-life issues entailed in caring for chronically ill older persons might greater inform nursing strategies, education, practice, and nursing research. In terms of education, Pangman and Seguire are keen to "influence student's [sic] attitudes and thinking processes" so that "more favorable attitudes toward sexuality and the elderly can be promoted" (54). Nurses, in their view, can also play "a significant role…