By RAMONIA W.
Associate Director of Nursing, SYNERGY HomeCare
The issue of Sexually Transmitted Disease/Infection (STD/STI) is a sensitive topic that can affect us all, including those who help loved ones in a home care assistance arrangement. STDs are not only very common but many can be affected and not even know that they have or have had an infectious disease. STDs respect no one. All persons of every social class, age, race and ethnicity are candidates. Also, those affected by dementia are not immune.
STDs are transmitted or spread through sexual contact or activity involving sharing “dirty” syringes. According to the CDC (2010), 19 million elderly in home care or in a facility for dementia patients are infected each year in the United States.
Meanwhile, the senior population has increased in contracting STDs due to the non-use of condoms and a weaker immune system. Dementia patients are acutely at risk. Their cognition is progressively decreasing giving rise to a lack of thinking, reasoning, and discernment.
However, this dementia does not mean a lack of sexuality. Dementia patients have a need for expressing intimacy and feelings and desire relationships as well. They may be just as sexually active as prior to their diagnosis. With these mental changes, the patient with dementia may experience a decrease in inhibitions and may show their affections and attentions to their partner or to someone they may not know.
In a facility or nursing-home setting – and even in home care in Oklahoma City — this is a difficult dilemma because dementia patients may wander into several resident rooms eliciting challenging sexual behavior. Note that I said “several” because the patient with dementia may have forgotten that they had just had a sexual encounter and have had a number of partners. Some encounters welcomed and some not welcomed. Staff members of a facility may be on the receiving end of the advancement or they could be the perpetrator of unsolicited sexual advancements. In any case, changes in the mental capacity related to medication treatment for dementia and the progression of the disease must be weighed regarding mutual and informed consent for sexual intimacy by the dementia patient.
STD symptoms may or may not be evident but can include discharge from the genitalia with a strong odor, burning or pain during urination, flu-like symptoms such as fever, headache, chills, achy joints fatigue, night sweats, painful ulcers, rash and itchy groin skin. Long-term health issues and consequences such as pelvic inflammatory disease (PID), cancer of the cervix, infertility and death can occur if the STD is not treated.
In a 2011 study, researchers have found that those carrying the herpes virus double their risk of developing Alzheimer’s through the production of amyloid plaques, a hallmark of Alzheimer’s disease. (Lövheim H, Gilthorpe J, Adolfsson R, Nilsson L-G, Elgh F. Reactivated herpes simplex infection increases the risk of Alzheimer’s disease. Alzheimer’s & Dementia. 2014.)
There are several types of the infection and, depending on the STD, it can be spread through contracting viruses and bacteria via the sex organs — vaginal, anal, mouth, oral to genital, sexual toys and coming in contact with blood during sexual activity. Chlamydia, Gonorrhea, Syphilis, Genital herpes (herpes simplex virus), Genital warts (human papillomavirus virus [HPV]), Hepatitis B, D, A, C, E, Human immunodeficiency virus (HIV/AIDS), Jock itch (Tenia cruris), yeast infections (Candida albicans), pubic lice or crabs and scabies are just a few STDs.
Treatment for STDs varies depending on the cause and includes aggressive oral medications, antibiotics, topical creams, antifungals, injections, immunizations to prevent hepatitis B, cryotherapy (freezing) or surgical excisions.
Prevention is the key.
Abstinence is the best way to prevent an STD. Monogamy and delaying sexual relations for as long as possible will decrease the risk of contracting an STD. Using a condom is only 90 percent effective so getting tested and receiving regular medical checkups is paramount.
Some testing and resources include:
— Crossroads Clinic provides free STD/STI Testing and Treatment. All services are free and confidential. Crossroads Clinic: 3077 E. College Ave. Guthrie, OK 73044 Hours: 9:30 a.m. – 5 p.m. (Mon – Thurs) Phone: 405.293.8378
There are also convenient home-testing kits that are confidential for a range of infections including STI/STDs with results being available within three to five days.
Or go online and checkout these websites for more information:
http://www.plannedparenthood.org/all-access/check#sthash.Y9mOeNse.dpuf
Resources: http://www.cdc.gov/std/hpv/default.htm
Resources: http://www.cdc.gov/std/general/hepatitis.htm
Resources: http://www.cdc.gov/std/hiv/default.htm
Resources: http://www.cdc.gov/std/syphilis/STDFact-Syphilis.htm
(Ramonia’s certifications include RN BSN MS VR RC CCM)
