Psychosocial wellbeing for older adults could be simply defined as they are living well emotionally and socially in old age. However, living well means different things to different people and each individual's experience of old age will be unique. It is realistic to acknowledge that change or loss might occur in old age, but it is still possible to live well despite this. The satisfaction possessed by an individual depends on how much they adjust to and cope with the changes and losses that occur. There are several dimensions of psychosocial wellbeing which are illustrated as below:

Self Reliance – The ability to remain independent and maintain autonomy. It is related to self-esteem and a positive self-image which contribute largely to emotional wellness.

Personal Growth – The continued growth and development of one's capacity within limitations of environment. Older adults are able to continue growth by participating actively in the society with an understanding of their own assets and limitations.

Purpose – Finding meaning in one's life. Older adults with their experience and wisdom could remain active and productive in the society.

Harmonious Relationship – Developing & keeping a trusting and caring relationship with family, relatives and friends. People will cope better with change and loss in old age if they have confiding interpersonal relationship.

From the perspective of older adults themselves

•  Active participation

Participate in group and community activities are ways to remain an active member in the society. Older adults are encouraged to maintain hobbies or develop new interests after retirement. Expanding social circle, getting along with others and keeping up with current trends are some secondary gains from joining those activities.

•  Contribution to family & society

Caring for family members and taking part in family issues contribute to sense of worth and enjoyment to the older adults. Acting as a grandparent to take care of the grandchildren has been highly emphasized in our society. Participating in volunteer works also bring you a sense of satisfaction by helping others with your invaluable experience.

•  Maintenance of emotional stability

Adapting to the changes in life role and living pattern is an essential process for older adults who have retired. Stress might exist and they are required to equip themselves with knowledge and skills to cope with the challenges of life.

From the perspective of other members in the society

•  Understanding of old age

Having an understanding about the changes in ageing help people realize the needs of older adults as well as develop a positive attitude towards them.

•  Giving support

Support could be given to the older adults concerning both their economic and emotional needs. Various community resources including financial assistance, residential assistance, health care assistance and counseling service could also be utilized to help those in needs.

Stress

•  Understanding stress

Some people have a misconception towards stress. They think stress is negative and unpleasant. In fact, some degree of stress is normal and desirable at times. It can motivate you to do something and improve yourself as well. A total absence of stress is undesirable which is always associated with inactivity and lack of motivation. It will be a problem if the amount of stress is overwhelming or continues over a sustained period of time. Having a balanced view of stress helps you to understand and cope with life changes.

•  Recognizing stress

Common sources of stress in old age:

♦ Ageing and diseases

♦ Changes in life role and living pattern

♦ Financial hardship

♦ Increase in dependency

♦ Changes in relationship with relatives and friends

♦ Death of loved ones

♦ Major changes in living environment e.g. moving house or moving from home to old age home

Signs and symptoms of stress:

•  Managing stress

i)  Tips for dealing with stress

•  Establish a healthy lifestyle with balanced diet, regular exercise & smoking cessation

•  Have a positive thinking. Try to view change as an opportunity for growth rather than as a threat to security.

•  Make good use of your leisure time. Participate in the activities which are enjoyable.

•  Learn time management. List the things you need to do and set priorities for them.

•  Appreciate your assets and efforts as well as accept your limitations.

•  Choose any of the following practical techniques for alleviating stress: deep breathing, warm baths, massage
(massage the tense muscles especially your back muscles), muscles stretching.

•  Share your feelings with family and friends. It is important for them to know how you feel so that they can help you.

•  Seek help from professional when you need it especially when you undergo a difficult period of time and your
tension from stress persists as well as it has not be solved from just sharing with family and friends alone.

ii) Stress management (for professionals)

The best way to manage stress is not to seek a state with no stress at all. However, stress management emphasizes one's own self-regulation which is a process of ongoing monitoring, assessment and utilization of one's coping resources. Nowadays, there are a variety of coping strategies and techniques which are found to be effective in overcoming stress. You might educate your clients to choose and practice any strategy or technique which suits their needs. Though some of them might not relieve a person entirely from the undesirable stress, they really help alleviate stressful conditions.

Related websites for stress coping & relaxation techniques:

• Relaxation exercises to reduce stress, AboutStress.com, Stress Management Institute, USA

• Manage stress, AARP , USA

• Progressive Relaxation, HealthWorld Online

•  Introduction

•  Benefits of grandparenting

i) For grandparents

•  Continuing the family line by getting involved in the lives of your children and grandchildren.

•  Being offered an opportunity for growth and learning from the interactions with the younger generations.

ii) For grandchildren & their parents

•  Developing a positive attitude towards ageing

•  Understanding your family's history and learning about the personal experience and wisdom of the older person.

•  Sharing the workload of parents in taking care of the children.

•  Suggestions for good styles of grandparenting :

•  Taking up the responsibility of grandparenting as a matter of choice rather than an obligation.

•  Acting as a role model for grandchildren by demonstrating good examples of attitudes and behaviors.

•  Striving for consistency with grandchildren's parents in disciplining and caring of grandchildren. Mutual
respect and exchange of views in child rearing among grandparents and parents should be emphasized.

•  Having enjoyment when getting along with grandchildren by spending time with them on holidays, developing
hobbies and going outings together.

•  Offering unconditional love, acceptance, appreciation and support to grandchildren.

•  Talking with grandchildren concisely and avoiding rambling or repeating.

•  Listening to your grandchildren actively and being prepared to talk about new and lively topics.

•  Related websites for grandparenting :

• Foundation for Grandparenting, USA
• Grandparenting information by AARP, USA
  

•  Introduction

The common myth in our culture about sexuality of older persons is that they do not and should not have sex. Two local studies revealed that this belief was strongly held by the elderly themselves as well. About two-third of the elderly respondents in a survey (1) regarded sexual life as not necessary to older persons and about 40% of male respondents in another study (2) considered sexual intercourse was harmful to elders' health. But it is interesting to find that more than half of the respondents in the latter study reported having sexual desire and intercourse in the past one year. Moreover, the percentage expressing satisfaction during sexual intercourse was high (60-80%) among those sexually active respondents. It is important to realize that sexuality is an integral part of the whole person and caters to the individual's lifelong need for emotional and physical intimacy. Most adults regardless of their age should be able to enjoy the satisfaction derived from sexual relationships.

(1) Christian Family Service Centre (1999). Study on elderly people's sexual attitudes, behaviours and ways of coping with sexual distress in Hong Kong . Hong Kong : Christian Family Service Centre.

(2) Chan C.N., Ho K.S., Heung C.L., Chan W.M. Study on knowledge, attitude and sexual behavior among the Chinese elderly males in Hong Kong. The Hong Kong Practitioner 2004; Volume 26.

•  What is sexuality?

Sexuality can mean many different things to different people. Although sexual intercourse is important in sexuality, the term has a much broader meaning. It is worth remembering that there are ways of expressing sexual feelings and achieving satisfaction other than sexual intercourse. Intimate behaviours such as kissing, holding hands, hugging, caressing and sharing of sexual related topics are some forms of expression of sexuality between partners. Adopting such definition will broaden our horizon towards sexuality and allow us to have a more accurate perception of sexual behaviours.

•  Normal changes in sexual functioning with age

Many surveys found that older women and men still enjoyed sex. Sexual interest and function do change with age, but not as much as people might think. The following table lists some examples of physiological and psychosocial changes with age for both men and women.

Erectile dysfunction (sexual dysfunction in older men)

Difficulty in completing sexual intercourse is not uncommon during lifetime and it may not exactly equal to sexual dysfunction. The common sexual dysfunction for man is called erectile dysfunction (or called impotence) which is defined as the inability to achieve or maintain an erection that leads to uncompleted sexual intercourse and sexual dissatisfaction consistently. In a local study, about 27% of the respondents aged 65 or above who were sexually active expressed difficulty in maintaining erection more than half of the occasions during sexual intercourse and about 7% had complete erectile dysfunction.

Is erectile dysfunction treatable?

There are a number of treatments available for erectile dysfunction. Among the various treatment options, oral medication such as Viagra has become the popular choice of treatment around the world. However, the medication has proved to have side-effect on cardiovascular system and not appropriate for use by individuals with severe hypertension and coronary heart disease. It is dangerous to take this medication without thorough medical investigation and doctor's prescription. The basic treatment principle for sexual dysfunction should involve identification and treatment of etiological factors. Sex education and counseling, lifestyle modification and optimization of the medical management of associated illnesses are usually the initial and appropriate treatment modalities.

Sexual dysfunction in older women

The commonly presenting symptom of sexual dysfunction for older women is the experience of painful or uncomfortable sexual intercourse. It is caused by the decrease in vaginal secretions and vaginal expansion during arousal after menopause or other disease-related factors. The symptom often serves as a deterrent to sexual intercourse, provoking withdrawal behaviours from sex and even loss of sexual desire. Artificial vaginal lubricants such as KY jelly are readily available and effective for this problem.

•  Suggestions for dealing with common sexual problems

• Keeping an open attitude towards sexuality and ageing will help you have a better understanding as well as clarify misconceptions.
• Caring relationship and frank communication between partners are pre-requisites for satisfactory sex.
• Some skills may help alleviate the sexual difficulties in late adulthood. Adequate rest before having sex, prolonged foreplay, change to less demanding postures for intercourse and use of artificial lubricant are simple and effective strategies for the problems.
• Do not take drugs (not prescribed by doctor), alcohol or other restoratives which may not be useful to sex performance and even harmful to your health. Consult physician if necessary. Sex education, counseling and support group often assists individual in the development of a positive self-image and enhance sexuality. Hong Kong Christian Family Service 耆性資源輔導中心 (Hotline﹕2191 2244) provides such services to older persons in Hong Kong.

•  Related websites for sexuality and ageing:

• 香港電台性本善Online長者通性

• The Family Planning Association of Hong Kong

• Men's Health, Department of Health

• Women's Health, Health Zone, Department of Health
  

• DIY自助式健康自學/教材套-長者與兒媳的關係(衛生署長者健康服務)

• DIY自助式健康自學/教材套-適應退休(衛生署長者健康服務)

• Healthy Lifesyles, Eldetrly Health Services, Department of Health

• Agency for Volunteer Service

• 長者人力資源庫(香港耆康老人福利會)

• 友待長者就業計劃(流金頌社區計劃)