If the thought of sitting down with your kids and having that awkward, frank discussion about sex and drugs is bad enough, just imagine what it’s like when it’s a senior citizen who needs “the talk”!
These days, the scenario is not as far-fetched as it may seem. Both misuse of drugs and the risk of sexually transmitted diseases (STDs) are rapidly emerging as major issues among the over 55 crowd. While the medications in question may be legitimate, as opposed to illicit, and the sexual situations different, the problems are just as real.

The 70-year itch
Let’s look at the facts, beginning with sex. More people in their 60s and 70s are beginning new relationships, which often means revitalized sexual activity. In a recent survey of people over 60 conducted by the National Council on Aging, more than half of the respondents reported having sex at least once a month, and an even higher percentage indicated that they wanted to do so more frequently.

Then there is the emergence of the so-called “Viagra generation.” Officially indicated for
sexual dysfunction, this “wonder drug” has had a tremendous impact on the lives of older adults. Since its introduction in 1998, Viagra sales have exceeded $2 billion worldwide. And Canada has claimed its fair share—with over 530,000 prescriptions written within the first 12 months of release!

Reports show that more than half of Viagra prescriptions have been written for men over 50. Other drug companies have been quick to jump on the bandwagon and have released competitive products such as Cialis and Levitra.

Still not convinced that seniors have sex on the mind? Consider this: while the number of prescriptions written for Viagra has more than doubled each year, its use for medical reasons has declined. In other words, these products are being used for recreational purposes, allowing many older men to revive dormant sex lives.

And why not? Men and women can derive physical and emotional enjoyment from sex at any age. Regular, pleasurable sex is important to overall health and can even increase longevity. A Swedish study of about 1,000 men between 45 and 65 years old showed that the men with an active sex life reduced their risk of dying by over 50 per cent.

Safe sex at any age
Unfortunately, there are sobering statistics to worry about. While sex can be beneficial, unsafe sex is dangerous. Sexually transmitted diseases know no age boundary. In fact, heterosexual men and women over the age of 50 have become the fastest growing HIV/AIDs demographic group. In New York City, 26 per cent of the HIV positive population is over 55. HIV isn’t the only STD to worry about. North American chlamydia rates continue to rise, and even syphilis is making a comeback.

Older adults, especially those returning to sexual activity (i.e., a woman who finds a new boyfriend after years of widowhood) are vulnerable. Just because the threat of pregnancy may no longer be an issue doesn’t mean that seniors can throw caution to the wind and practise unsafe sex.

Unlike younger generations, seniors have not been bombarded with safe-sex campaigns. Even today, simple educational programs, such as the importance of using a condom, ignore this age group. An Emory University study found that many women over 50 are “extremely uninformed” about the spread of STDs.

Those who enjoyed long, monogamous relationships until the death of their partners may have never had to think about—let along practise—safe sex.

And a word of caution—although many seniors see their doctors on a regular basis, health care providers don’t always acknowledge that their older patients may need sex education. Even doctors who prescribe Viagra, or other so-called sexual dysfunction drugs, may not bring up the subject of STDs.

So, it may be up to you to “have that talk” with an older mother or father who is considering getting back on the dating scene. If that’s too embarrassing, try leaving some information pamphlets on safe sex lying around, or tip-off your parent’s physician, and ask him or her to bring up the “whys” and “hows” of safe sex.

The dangers of medication misuse
As if worrying about sex wasn’t enough, medications are an even bigger concern. Drug misuse is a serious problem among Canada’s elderly. A recent CBC News investigation found that seniors account for 44 per cent of fatal adverse drug reactions, even though they comprise only 13 per cent of the population. And a U.S. study suggests that almost one in five seniors misuses or abuses their prescription or over-the-counter medications.

The reasons aren’t hard to figure out. Seniors simply use more medications than the general population, frequently taking a cocktail of pills for numerous chronic conditions. It’s not unusual for a person over 60 to be taking from five to 10 more prescription medications simultaneously—with the most popular being drugs for heart problems, blood pressure, and arthritis. Medications for depression, anxiety or sleep problems are also high on the list. Top this off with regular use of over-the-counter (OTC) medications, and you have a dangerous recipe.

Then there is the aging process itself. Physiological changes compromise the body’s ability to metabolize certain drugs and reduce tolerance levels. Add to this the potential memory and cognitive impairments of aging (for example, forgetting to take a pill or mixing up which pill to take and when) and the potential for confusion and misuse increases.

The good news is that the dangers can be reduced with a few simple strategies. The key is to be proactive. Start by conducting a complete medicine review with your elderly loved one. Ask if you can accompany them on the next doctor’s or pharmacist’s appointment and take along all the medications they are taking—both prescription and over-the-counter (and don’t forget any herbal products).

Clarify what they are taking and why. Ask questions, and encourage your loved one to talk about any problems, side-effects or confusion they are having. Then put in place a personal “drug safety strategy” (see Seven best steps to safe medication use) designed to help reduce the risk of accidental drug misuse. Don’t be afraid to ask for advice from the doctor or pharmacist in this regard.

Know the risks
Whether it’s sex or drugs, the key to safety is awareness and education. Knowing the risks
is important. So don’t be shy to bring up the subject. A little awkwardness today could make a big difference in the future by ensuring your loved ones gets only the benefits of their sex lives and the medications they are taking.

Ian Corks is the Medical Editor of Solutions magazine.