Content area
1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf . To obtain contact hours you must:
1. Read the article, "Older Adults Engaging in Online Dating: What Gerontological Nurses Should Know" found on pages 25-35, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.
2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.
3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated.
This activity is valid for continuing education credit until September 30, 2018.
This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.
Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
1. Review the findings of a literature review that was designed to examine the body of evidence related to older adults who engage in online dating.
2. As a result of the review, highlight the clinical implications for nurses when assessing older clients in relation to their online dating practices.
Neither the planners nor the authors have any conflicts of interest to disclose.
Many older adults maintain interest in intimate partner relationships and actively seek dates. Online dating websites are gaining popularity as being a convenient way to link with potential dates, particularly for women and individuals who live in independent dwellings or rural areas. Several online dating websites market exclusively to individuals 50 and older. Although connecting with others via the Internet can decrease social isolation, there are potential risks involved in online dating. Health care providers do not always assess dating and sexual health in the older adult population. Nurses are in a position to assess the dating relationships of older patients and can ask targeted questions to determine if patients are in a potentially risky relationship. A non-judgmental attitude and compassionate approach is essential. Knowledge of safe practices, alerting red flags, and available resources are essential tools for gerontological nurses to possess. [ Journal of Gerontological Nursing, 41 (10), 25-35.]
Ms. Wion is PhD Student, and Dr. Loeb is Associate Professor of Nursing and Director of PhD Program, College of Nursing, Pennsylvania State University, University Park, Pennsylvania.
The authors have disclosed no potential conflicts of interest, financial or otherwise.
Approximately 30 years of research has shown that older adults maintain interest in intimate partner relationships well into old age. Some older adults seek such relationships through the process of dating ( Brown & Shinohara, 2013 ; Bulcroft & Bulcroft, 1991 ; Bulcroft & O'Connor, 1986 ; Carr, 2004 ; Dickson, Hughes, & Walker, 2005 ). Dating is important for older adults, but also opens them up to risks associated with forging new relationships, especially if dates are with an individual who is previously unknown. A recent study using a U.S. representative sample found that 14% of unmarried adults ages 57 to 85 were in dating relationships ( Brown & Shinohara, 2013 )-a statistic that is likely to grow due to factors such as divorce and greater life expectancy. Older adults have many reasons for seeking a new relationship, including companionship ( Bulcroft & O'Connor, 1986 ; Dickson et al., 2005 ), emotional support ( Bulcroft & O'Connor, 1986 ; Carr, 2004 ), prestige, a desire to share their life ( Bulcroft & O'Connor, 1986 ), and sexual intimacy ( Bulcroft & O'Connor, 1986 ; Dickson et al., 2005 ). Older men may date in pursuit of the stability and domestic help that comes with being married, whereas older women may be more disinclined to pursue marriage at least in part due to the caregiving role that often comes with having a spouse ( McIntosh, Locker, Briley, Ryan, & Scott, 2011 ).
Some older adults seek relationships via less traditional venues, such as online dating. Online dating websites for older adults designate the age of users as being 50 and older. Online dating affords greater opportunity for individuals in living arrangements that offer less chance for impromptu socializing (e.g., independent dwellings, rural areas) ( Bulcroft & Bulcroft, 1991 ) and for women who encounter a smaller dating pool in their day-to-day lives ( Dickson et al., 2005 ). The Internet has provided older adults with the chance to connect with others regardless of geographic location ( McIntosh et al., 2011 ) and has been identified as an important part of decreasing social isolation in older adults ( Alterovitz & Mendelsohn, 2013 ). The potential impact of online dating is highlighted in Sassler's ( 2010 , p. 567) assertion that as Baby Boomers leave the workforce, "increased life expectancy, good health, changing sexual attitudes, the growing acceptance of pharmaceutical sexual interventions...and the rise in Internet dating and retirement communities-will undoubtedly change the romantic options available to older adults."
Older adults are becoming more familiar with the technology needed to date online. Among adults 65 and older, 53% use e-mail or the Internet and, of those, 70% report daily Internet use ( Zickuhr & Madden, 2012 ). Two perceived benefits of Internet use by older adults are providing a way to connect with others ( Doyle & Goldingay, 2012 ; Gatto & Tak, 2008 ) as well as offering a sense of community ( Sum, Mathews, Pourghasem, & Hughes, 2009 ). One frustration with online environments is the lack of direct human contact ( Heinz et al., 2013 ). This research finding suggests that older adults may be particularly interested in connecting with potential romantic partners face-to-face after an initial online contact-a phenomenon that could place them at a greater safety risk.
The purposes of the current literature review are to (a) examine the body of evidence related to older adults engaging in online dating and (b) highlight the clinical importance of nurses assessing for this type of dating by older adult patients. Promoting awareness of online dating practices of older adults and the risks associated with online dating can promote the safety of individuals who meet potential dates via dating websites and other online venues. Table A ( available in the online version of this article ) gives in-depth information about the studies cited in the current article whose results focused on older online daters.
The level of evidence for the studies was determined using the criteria based on the Johns Hopkins Nursing Evidence Based Practice (JHNEBP; Poe & Costa, 2012 ) Rating Scale. The JHNEBP Rating Scale has two components: strength and quality of the evidence ( Poe & Costa, 2012 ). Strength of the evidence is rated by assigning the study a level from one to five. Level one is considered the strongest and level five is considered the weakest strength. Quality of evidence is rated by assigning the study a grade from A to C. Studies with As are of the highest quality, studies with Bs are of good quality, and studies with Cs are of low quality or have major flaws ( Poe & Costa, 2012 ). Evidence ratings for the older adult online dating literature are located in Table A (available in the online version of this article.).
Motivations for Older Adults Dating Online
The Internet and other forms of social media have opened romantic possibilities for older adults. Approximately 45% of adults 45 and older in the United States have used the Internet to find individuals they have previously dated and 17% have dated online ( Smith & Duggan, 2013 ). Many older adults turn to online dating when looking for romantic and/or intimate relationships ( Adams, Oye, & Parker, 2003 ; Alterovitz & Mendelsohn, 2009, 2013 ; Bateson, Weisberg, McCaffery, & Luscombe, 2012 ; Jonson & Silverskog, 2012 ; Malta, 2007 ; Malta & Farquharson, 2014 ; McIntosh et al., 2011 ; McWilliams & Barrett, 2014 ; VandeWeerd et al., 2014 ). In a survey of 500 online daters 50 and older, AARP ( 2012 ) found that the top reasons for dating online were (in descending order) (a) to find a serious relationship, (b) friendship/companionship, (c) casual dating, (d) intimacy/sexual relations, and (e) other.
McWilliams and Barrett ( 2014 ) conducted a qualitative study of 18 older adults who used online dating as a means of meeting potential romantic interests. There was a transition period between the end of the participants' previous marriage and when they were ready to date. The length of time before pursuing a new relationship was shorter for men (<2 years) than women (>4 years) regardless of whether they were a divorcee or widow. Men viewed online dating as a way to quickly find dates, whereas women viewed it as a means for slowly easing into a new relationship and taking the time to get to know someone before meeting face-to-face ( McWilliams & Barrett, 2014 ). Using the Internet for dating may be especially appealing to older women because it allows them to exercise more control over the process than when they were younger, as men of their generation were more likely to "call the shots" when it came to dating ( McWilliams & Barrett, 2014 ).
McWilliams and Barrett ( 2014 ) found that men were more interested in relationships that led to a deeper commitment, such as marriage, whereas women wanted the intimacy and companionship that a relationship afforded but did not want to be married. Women expressed that they had no desire to become a caregiver in the sense of medical and household duties. Men wished they had someone to help with instrumental tasks as well as emotional support ( McWilliams & Barrett, 2014 ). In another large study of online daters 40 and older ( N = 1,113), 14.4% were looking for companionship and 15.8% were seeking a short-term relationship ( Bateson et al., 2012 ).
Dating websites exist that specifically market to individuals 50 and older (e.g., Our Time, Senior FriendFinder) and some that target older adults who are lesbian, gay, or bisexual (e.g., Senior Gay Dating) ( Adams et al., 2003 ). These types of websites may be perceived as safe places where users feel free to express themselves and find like-minded individuals ( Adams et al., 2003 ). Many older adults have dating profiles on more than one social networking site ( VandeWeerd et al., 2014 ). Dating online has been described as being confidential, secure, and private by some older adults ( Malta, 2007 ). Online dating is viewed as being an easier way to meet potential dates when compared with trying to find a romantic partner in person ( Malta, 2007 ; McWilliams & Barrett, 2014 ). In addition, online dating is perceived to make it easier to leave relationships ( Malta & Farquharson, 2014 ). Dating online also allows for a vetting process that helps lessen the impact of immediate rejection ( Malta, 2007 ).
Practices, Experiences, and Beliefs of Older Adults Engaged in Online Dating
Practices
Similar to their younger counterparts, older adults who date online struggle to market themselves in the best light as a means for attracting attention to their dating profile or personal advertisement ( Adams et al., 2003 ). When creating a dating profile, older daters are challenged to achieve the delicate balance of embracing their age and experiences while still sounding youthful-all in the hopes of attracting the "right" person ( Adams et al., 2003 ). McWilliams and Barrett ( 2014 ) found that women used their profiles to project an image of youthful femininity by stressing physical attractiveness and active social lives. Male participants' profiles also focused on youth, but financial and work successes were also highlighted prominently ( McWilliams & Barrett, 2014 ). In a study of online dating profiles of lesbian, gay, bisexual, and transgender participants 60 and older, Jonson and Siverskog ( 2012 ) found that many used a humorous, self-mocking approach in their profiles; these daters tended to be upfront with references to aging and sexual difficulties and used humor as a way of deflecting potentially uncomfortable or embarrassing subjects. Many profiles also referenced youth and looking/feeling years younger than the actual biological age ( Jonson & Siverskog, 2012 ).
In VandeWeerd etal.'s ( 2014 )study, participants reported that the online dating environment allowed them to get to know a potential partner before meeting in person. Dating profiles also provided a means for daters to "weed out" individuals who could potentially become a burden or were otherwise not a compatible match. For example, McWilliams and Barrett ( 2014 ) found that one participant would look at profiles of potential dates as a barometer of overall health and would bypass individuals who did not eat healthy or did not mention liking a physical activity. Men and women valued youthfulness. Men were also focused on physical attractiveness, whereas women prized physical ability, effective communication, and intelligence ( McWilliams & Barrett, 2014 ).
Alterovitz and Mendelsohn ( 2009 ) examined online personal advertisements placed by older adults and found that men preferred to date younger women. The gap in age preference increased as men aged. This preference of dating younger women was echoed in a study by McIntosh et al. ( 2011 ) when comparing older and younger men. Conversely, women preferred to date men who were older than themselves until the women reached age 75, after which they preferred to date younger men ( Alterovitz & Mendelsohn, 2009 ). In the study by McIntosh et al. ( 2011 ), women 65 and older were more likely to have a lower minimum age criterion for potential partners compared to women between the ages of 25 and 35. Women were also more selective in terms of characteristics sought when explicating partner preferences as compared to men ( Alterovitz & Mendelsohn, 2009 ).
In a more recent study, Alterovitz and Mendelsohn ( 2013 ) compared online personal advertisements of a geographically diverse sample of 450 individuals (evenly divided by group and gender), who were middle-aged (40 to 54 years), young-old (60 to 74 years), and old-old (75 and older), in relation to the dependent variables of loneliness, health, adventure-seeking, looking for a soul mate, romantic activities, and sexual interests. Although there was no significant difference between young-old and old-old participants' inclusion of loneliness in advertisements, young-old individuals were significantly more likely to mention that they were seeking adventure, searching for a soul mate, desiring romantic activities, and looking to engage in sexual activities. The latter was relatively low in both groups, with 10% of young-old and 2% of old-old individuals reporting this interest. Health was the one topic that old-old participants (39.3%) were more likely than the young-old (19.3%) to include in online personal advertisements.
One factor that promotes dating among older adults is willingness to be located at a further driving distance away from potential dates as compared to younger adults ( McIntosh et al., 2011 ). Conversely, older adults' reluctance to date outside their own race or religion as well as a tendency to require a higher minimum income from a potential partner than younger adult counterparts may serve as impediments to dating ( McIntosh et al., 2011 ). This reluctance can restrict the potential pool of partners for men and women, but especially women ( McIntosh et al., 2011 ) because men are more likely to seek younger partners ( Alterovitz & Mendelsohn, 2009 ).
As previously mentioned, some older adults desire a sexual relationship when looking for romantic partners. In a small study ( N = 7), Malta ( 2007 ) found that all but one participant engaged in sexual relations the first time meeting face-to-face. The time from first meeting online to a sexual relationship ranged from approximately 4 months to 1 year. In a sample of 1,113 adults ages 40 and older who used an online dating site, Bateson et al. ( 2012 ) found in the past year that approximately 40% of participants had sex with at least one new partner they had met online; 23.3% had one new partner, 13.7% had two to three new partners, and 4.2% had four or more new partners. Although Malta ( 2007 ) did not cover safety concerns of a sexual relationship with participants, Bateson et al. ( 2012 ) compared the safe sexual practices of women age 40 and older with women younger than 40 in those who used an online dating website. Older women were significantly more likely to talk with a sexual partner about sexually transmitted diseases (STDs); however, they also were more likely to have sex without a condom ( Bateson et al., 2012 ).
Experiences
In one study, 84.4% ( n = 45) of older adult participants who were interested in dating online reported having a prior relationship through this medium ( VandeWeerd et al., 2014 ). By dating and meeting individuals online, some older adults built relationships that were meaningful and long-lasting ( Malta, 2007 ). Malta ( 2007 ) found that most romantic relationships between older online daters developed quickly-within 1 to 6 months of initial contact. Most of these romantic relationships had been maintained for 3 to 10 years. Interestingly, most of the participants indicated they would not turn to online dating if they became single in the future; however, they would recommend it to others as a means for finding a romantic partner. Of the romantic relationships that did not last, the mean length of time was 4 months of dating ( Malta, 2007 ).
Beliefs
In Malta's ( 2007 ) study, more than one half of participants were supportive of cyber flirting and had engaged in cybersex before and after becoming sexually active in real life. Cyber cheating was generally seen as something that was not acceptable. However, some participants responded that cyber cheating was acceptable as long as sex in real life did not happen. Specific situations where cyber cheating was deemed allowable were if the partner had dementia, was no longer able to perform sexually, and/or was away for long periods of time.
Dating and Relationship Risks for Older Adults
A paucity of research exists on the subject of intimate partner violence, elder abuse, and financial abuse in the context of older adults who are dating. All older adults are at risk for abuse despite their gender, age, socioeconomic status, and culture ( Fitzwater & Puchta, 2010 ). Unfortunately, information regarding intimate partner violence, an especially egregious form of abuse, in older adults is generally lacking and national prevention and educational campaigns for intimate partner violence and/or dating violence do not focus on this age group ( VandeWeerd et al., 2014 ).
Older adults are at risk for intimate partner victimization. Data on emotional, physical (including sexual), and financial intimate partner victimization in married or formerly married adults age 60 and older were analyzed from the 1999 and 2004 Canadian General Social Survey ( Poole & Rietschlin, 2012 ). The 5-year prevalence for abuse was 6.8% of the older participants. Emotional abuse was the most common (6.3%), then financial abuse (1.2%), and lastly physical abuse (0.9%). Of individuals who reported some form of abuse, 28% experienced more than one type. Men and women experienced similar amounts of emotional and physical abuse, whereas women were significantly more likely to be abused financially. Incidences of abuse declined with age for individuals who were not in relationships, whereas age had no effect on abuse in individuals in current relationships. For individuals who experienced physical abuse, the probability of being abused was greater if they were in a relationship for ≤10 years. Individual factors that made an individual more likely to be abused were having disabilities and being on medications for depression, sleep, or anxiety ( Poole & Rietschlin, 2012 ).
General Risks Involved in Online Dating
Although an online dating environment has opened up romantic possibilities for individuals of all ages, it has also provided an easier means for perpetrators to take advantage of others (e.g., sexual predators looking for potential victims) ( Coleman, 2014 ). Internet dating scams are becoming more prevalent. One Internet dating scam becoming more common involves a perpetrator building a relationship with a potential victim over a period of months and then convincing the victim that he/she needs a large amount of money ( Whitty & Buchanan, 2012 ). They usually present the need for money as an emergency with which only the victim can help ( Whitty & Buchanan, 2012 ). Victims of this type of scam are manipulated by their romantic relationship with the perpetrator and comply with the request. These scams are typically led by organized international groups ( Buchanan & Whitty, 2014 ). In a large study ( N = 853) of online daters, of 826 participants who answered the question about whether they had been a victim of an online dating romantic scam, 13% had been a victim of a scam but had not lost money and 2.4% had been the victim of a scam and lost money ( Buchanan & Whitty, 2014 ). Of participants who lost money, the range was from <$160 to >$160,000, with the mode between $1,601 and $16,000 ( Buchanan & Whitty, 2014 ).
Whitty ( 2013 ) explored the experiences of individuals who were victim of at least one online romance scam in a qualitative study of 20 adults ages 38 to 71. These relationships lasted from months to 4 years. Four participants had not yet been scammed, but still felt victimized ( Whitty, 2013 ). Similarly, Buchanan and Whitty ( 2014 ) found that many individuals who had been scammed but did not lose any money still felt emotional distress related to the loss of a relationship. In Whitty's ( 2013 ) study, some participants were scammed through numerous fake online relationships. One extreme example is the case of a man who reported being scammed in 40 such relationships. Apparently, perpetrators sell lists of easy targets to other perpetrators looking to scam individuals through online dating.
The type of scams varied, with some being elaborate. One common scam was after the relationship developed, the perpetrator asked for money so that he/she could fly to the victims' hometown and build a life together; however, after obtaining the money, he/she never showed and would claim some hardship stopped him/her from boarding the plane and he/she needed more money to get through the hardship. These requests for money would last until the victim cut ties completely. In a different scam, the perpetrator said he/she needed to borrow money for a business venture. A fairly common scam involved victims thinking they were building a relationship with a soldier who was soon to leave the military service. The perpetrator would ask the victim to take care of his/her personal belongings in anticipation of the perpetrator's move to the victim's hometown. The victim would receive a call from the "airport" that the diplomatic seals on the bags were going to expire and needed to pay a fee to get the bags released. Some women described this scam as being so extremely elaborate that they flew to Ghana to sign documents to pick up the bags but were subsequently kidnapped and kept by men with guns for several days until they signed the documents. Once released, the women still did not know they were being scammed and continued to send money. A few participants reported being taken advantage of sexually when they told their romantic partner that they could not financially afford to send money. The victims were told to perform sexual acts in front of a webcam, which the perpetrators recorded and then used to blackmail the victims ( Whitty, 2013 ).
Common to online dating romance scams was that the perpetrator or an individual working with the perpetrator was identified as being in a position of authority (e.g., lawyer, doctor, law enforcement) ( Whitty, 2013 ). Often the scenario in which the perpetrator asked for money was presented as being dire. Sometimes the perpetrator threatened to terminate the relationship if the victim was unable to help financially. Victims believed they had a deep connection and were in love with their partners in these relationships, which was why they were willing to give money ( Whitty, 2013 ). This finding aligns with a finding by Whitty and Buchanan ( 2014 ) of a personality trait significantly predictive of falling victim to an online dating romance scam: having romantic beliefs with idealization. Whitty ( 2013 ) also found that other participants felt almost an addiction to the relationship and continued even after suspecting it might be a scam. A majority of the participants reported that during at least one point in their relationship with the perpetrator, a friend or family member brought up the possibility that they might be victim of an online romance scam; however, the victims were able to reason away these concerns due to the deep love for their online romantic partners ( Whitty, 2013 ).
Other risks are involved in online dating that go beyond the online romance scams, such as intimate partner violence ( VandeWeerd, 2014 ). Others risks include being lied to or experiencing other forms of deceit, emotional risks, sexual risks (e.g., pregnancy, STDs), violence, risks of personal information being compromised ( Couch, Liamputtong, & Pitts, 2012 ), and risks of being exposed as an online dater to friends, family members, or employers ( Couch & Liamputtong, 2007 ).
Many online daters use measures in an effort to prevent becoming a victim. Couch, Liamputtong, and Pitts ( 2011 ) conducted a qualitative study of 29 participants ages 18 to 70 who dated online to ascertain how they use technology to avoid the risks involved in online dating. Most participants were concerned about being deceived by potential romantic partners and wanted to make sure they were authentic. Some ways participants assessed the authenticity of potential dates included making sure the potential date posted a picture in his/her online profile and used a webcam, online chatting, connecting through other social media (e.g., Facebook ® , MySpace ® ), connecting via phone calls, and searching for him/her online via his/her Internet Protocol (IP) address and/or name. Participants could see if the IP address city matched the city in which the dater claimed to live. Some older participants were particularly savvy using the Internet to track potential dates. A 60-year-old participant used Google ® to aid in tracking his potential dates and shared information on any he found to be scammers via a scammers awareness website. A 70-year-old participant also used Google to search his potential dates and could determine if they were authentic or not via the search. Another way of eliminating a potentially risky dating partner was to friend them via social media to see how they interacted with others. Participants also used technology to help control how much about themselves was shared with others. Methods used to control information access included waiting to share photographs until photographs of the potential dater were shared first, having two different instant message accounts and giving out the one less used first, and having two different cell phone numbers and again giving out the one less used first. Some participants refused to connect via other social networking sites until having met face-to-face. Participants also blocked individuals who they believed were trying to scam them ( Couch et al., 2011 ).
Risks Involved in Online Dating for Older Adults
Little research has been conducted on the possible and actual risks posed to older adults who use online dating websites. There are positive and negative aspects of using the Internet to date ( VandeWeerd et al., 2014 ). It has been suggested that the Internet provides an environment that could potentially promote abuse in online daters. Individuals who commit intimate partner violence can look at the dating profiles of potential victims as an easy way of finding those who are vulnerable (e.g., disabled, socially isolated, having self-esteem issues) to abuse. Older adults as a group may be less equipped to deal with online predators and are not aware of the extent of the risks involved in online dating ( VandeWeerd et al., 2014 ).
One risk to older adults who secure dates online is younger users may engage with them with the specific intent to harass, demean, and/or ridicule (i.e., "troll") them for trying to date at older ages ( Adams et al., 2003 ). Another risk is that the older dater may be exploited by his/her romantic partner through posting private pictures and videos on public websites ( Adams et al., 2003 ). Older daters also may be highly likely to believe what they read in the dating profiles of potential mates. VandeWeerd et al. ( 2014 ) found that 88.9% of the sample thought that the individuals they met online were truthful in the information they presented. In a qualitative study, Lawson and Leck ( 2006 ) found that one older participant believed that the long-distance relationship he built with his potential partner over a period of months made him trust her and have absolutely no doubt that she would be the same in person as she presented in e-mails and phone conversations. Conversely, VandeWeerd et al. ( 2014 ) noted a disconnect between how potential dates sometimes presented themselves online and how they were in person. Another risk was the compromise of personal information. Couch et al. ( 2012 ) gave an example of how a 59-year-old participant had a man show up at her home unannounced. The man had found out where she lived as well as other personal information about her through his own online investigation ( Couch et al., 2012 ).
One study examined adverse events that happened to older adult women who dated using MySpace ( VandeWeerd et al., 2014 ). Sixty percent of participants reported experiencing an individual asking for money, access to their bank account, or credit card numbers, and 40% believed an individual had tried to take advantage of them financially. More than one half (51.1%) of participants felt unsafe due to using MySpace, with 56.6% having felt physically, sexually, or verbally threatened, and 37.7% were physically harmed as a result of seeking new companions or friends via MySpace ( VandeWeerd et al., 2014 ). Of participants who experienced abuse via MySpace ( n = 35), only 17.1% reported it to a family member or friend and none reported it to the police ( VandeWeerd et al., 2014 ).
Sexual risk taking (e.g., engaging in sex without a condom) can also have negative health outcomes for older adults. Bateson et al. ( 2012 ) found that online daters with riskier attitudes regarding safe sex were more likely to be older, have a longer experience with online dating, have engaged with greater numbers of new sexual partners during the past year, and have a history of a STD. Savvy online daters are aware of this sexual risk taking and can use it to their advantage. One participant in a study admitted to having two Internet dating profiles-one where he stated his real age to find a girlfriend and another where he pretended to be older to find older women exclusively for sexual encounters because he perceived that they were less concerned about using condoms ( Couch et al., 2012 ).
Clinical Considerations
Older adults may not be aware of the risks involved in online dating. An important venue for screening and education regarding these risks is during the health care visit. Health care providers may be uncomfortable discussing these topics with patients 50 and older or may be unaware that these patients are seeking dating relationships. Performing a sexual health assessment on all older patients is a gateway to determining if they are dating or a victim of intimate partner victimization, or at risk of becoming a victim.
Some providers know of the stereotype of older adults being asexual but still tend to not ask questions related to sexual health and safe sex ( Gott, Hinchliff, & Galena, 2004 ). Providers find it more difficult to initiate these conversations with older patients compared to younger patients. Health care providers may be worried that asking about sexual health will offend patients and damage the provider-patient relationship. Other providers believe older adult patients may look to them for permission to become sexually active when pursuing new relationships after widowhood or divorce. Providers may be hesitant to discuss safe sex with older patients even if they know they are in a new relationship ( Gott et al., 2004 ). As one general practitioner said in relation to talking about safe sex with an older patient in a new relationship, "Usually the context [of the office visit] seems totally inappropriate" ( Gott et al., 2004 , p. 2,098). Findings from Farrell and Belza's ( 2012 ) study supports the point that sexual histories are not a routine part of older adult primary care visits, as evidenced in their finding that only 32.3% of older adult participants were asked about their sexual health during provider visits.
Implications for Nursing
Nurses in all settings are often part of the front line in patient interactions. Nurses are well positioned to assess whether older patients are engaging in online dating relationships and if there are any risks involved, such as physical, verbal, sexual, or financial abuse. Older patients, especially women, may be amenable to talking to nurses about issues related to sexual health ( Farrell & Belza, 2012 ). It is essential during assessment to be aware that abuse and sexual health risks are sensitive topics, so the most compassionate, non-judgmental approach, as well as maintaining strict confidentiality, is important. If the patient is joined by a friend or family member, he/she should be asked to step out of the room.
Assessment of Dating Relationships in Older Adult Patients
Knowledge of current technology and social media use in forming dating relationships is imperative if public health practitioners are to understand the decision-making processes that lead to romantic and sexual interactions ( Couch & Liamputtong, 2007 ); gerontological nurses working in community settings are one such group of practitioners. Some scenarios of online romance scams and what nursing can do to help are presented in Table 1 .
A simple yes or no question as to whether the older adult is dating or looking to date can open the lines of communication. More open-ended questions can proceed from here. The method of dating and types of romantic partners can be determined. Targeted assessment questions can be posed to determine if any sexual health risk factors exist or if the patient is currently in an abusive relationship or at risk for being abused. Ask whether the patient is afraid for his/her safety. Also ask if he/she is worried about his/her finances. If he/she indicates that he/she has been abused in the relationship, it is important to give time to allow the story to be heard ( National Association of State Units on Aging, 2006 ). Offer compassion, but respect and support the patient's wishes. Provide resources and refer the patient to supportive agencies ( National Association of State Units on Aging, 2006 ). Nurses are mandatory reporters in regard to abuse of senior citizens and any suspicions should be reported to Adult Protective Services.
Older patients in online dating relationships may be sexually active. Individuals in this age group may not be aware of the sexual health risks involved in sex without condoms ( Qaseem, Snow, Shekelle, Hopkins, & Owens, 2009 ). Older patients may be more hesitant to talk about their sex lives as well. One way to assess this aspect of their care is to use the PLISSIT (Permission, Providing Limited Information, Specific Suggestions, and Intensive Therapy) model ( Wallace, 2008 ). Permission is asking the patient if it is alright to discuss his/her sexual health. Providing limited information is based on the age-related changes that can affect sexual health and how much the patient wants to know about the problem ( Wallace, 2008 ). For example, if the patient reports having condomless sex, the nurse can educate him/her about the increased risk of STDs given physiological changes, such as thinning and friability of the vaginal walls. Specific suggestions would be to recommend condom use or alternative ways to express sexuality if the patient is unable to use a condom ( Wallace, 2008 ). Intensive therapy is not recommended for all patients; however, if a patient reports sexual abuse, the appropriate referral should be made ( Wallace, 2008 ).
Education Concerning Online Dating and Safety
One of the responsibilities of nurses is to educate patients about health promotion and disease prevention. When learning that an older patient is dating via online websites, nurses can provide information to help keep him/her safe ( Table 2 ). This can be done even before the patient starts dating, as the tips are important in the vetting process related to potential dates. Patients should also be educated regarding safe sexual practices and STD testing should be offered. Unfortunately, some patients may have already been victimized in their online relationship(s). If this is the case, information should be provided about how to get help and referrals should be made if needed. Table 3 shows resources for providers and patients.
Strength of Evidence of Older Adult Online Dating Literature
All of the studies reviewed in the current article were rated at level 3 because they were either cross-sectional or qualitative. The majority of the studies ( n = 7; 70%) had a quality rating of B (good), 20% ( n = 2) had a quality rating of C (low), and 10% ( n = 1) had a quality rating of A (high). The future work of researchers focused on online dating in older adults should take the important next steps of developing and rigorously testing intervention strategies for promoting the safety of older adults who meet partners on electronic dating websites.
Conclusion
Individuals 50 and older continue to want to date as they age. Online dating websites provide an easily accessible venue to meet potential dates. Unfortunately, the convenience of online dating has resulted in readier access to potential victims for individuals who wish to take advantage of others. Nurses are well-positioned to educate patients about the potential downfalls of using online dating and provide information on how to remain safe in online social environments.
AARP. (2012). AARP online dating survey: November 2012. Retrieved from http://www.aarp.org/content/dam/aarp/research/surveys_statistics/general/2012/AARP-Online-Dating-Survey-AARP.pdf
Adams M.S., & Oye J., & Parker T.S. (2003). Sexuality of older adults and the Internet: From sex education to cybersex. Sexual and Relationship Therapy, 18, 405 - 415. 10.1080/1468199031000153991
Alterovitz S.S.R., & Mendelsohn G.A. (2009). Partner preference across the lifespan: Online dating by older adults. Psychology and Aging, 24, 513 - 517. 10.1037/a0015897
Alterovitz S.S.R., & Mendelsohn G.A. (2013). Relationship goals of middle-aged, young-old, and old-old Internet daters: An analysis of online personal ads. Journal of Aging Studies, 27, 159 - 165. 10.1016/j.jaging.2012.12.006 23561281
Bateson D.J., & Weisberg E., & McCaffery K.J., & Luscombe G.M. (2012). When online becomes offline: Attitudes to safer sex practices in older and younger women using an Australian Internet dating site. Sexual Health, 9, 152 - 159. 10.1071/SH10164
Brown S.L., & Shinohara S.K. (2013). Dating relationships in older adulthood: A national portrait. Journal of Marriage and Family, 75, 1194 - 1202. 10.1111/jomf.12065 24319296 3848887
Buchanan T., & Whitty M.T. (2014). The online dating romance scam: Causes and consequences of victimhood. Psychology, Crime, & Law, 20, 261 - 283. 10.1080/1068316X.2013.772180
Bulcroft K., & O'Connor M. (1986). The importance of dating relationships on quality of life for older persons. Family Relations, 35, 397 - 401. 10.2307/584367
Bulcroft R.A., & Bulcroft K.A. (1991). The nature and functions of dating in later life. Research on Aging, 13, 244 - 260. 10.1177/0164027591132007
Carr D. (2004). The desire to date and remarry among older widows and widowers. Journal of Marriage and Family, 66, 1051 - 1068. 10.1111/j.0022-2445.2004.00078.x
Coleman P. (2014). Online dating: "Murderers, rapists, and con artists, oh my." Appalachian Journal of Law, 13, 147.
Couch D., & Liamputtong P. (2007). Online dating and mating: Perceptions of risk and health among online users. Health, Risk, & Society, 9, 275 - 294. 10.1080/13698570701488936
Couch D., & Liamputtong P., & Pitts M. (2011). Online daters and the use of technology for surveillance and risk management. International Journal of Emerging Technologies and Society, 9, 116 - 134.
Couch D., & Liamputtong P., & Pitts M. (2012). What are the real and perceived risks and dangers of online dating? Perspectives from online daters. Health, Risk, & Society, 14, 697 - 714. 10.1080/13698575.2012.720964
Dickson F.C., & Hughes P.C., & Walker K.L. (2005). An exploratory investigation into dating among later-life women. Western Journal of Communication, 69, 67 - 82. 10.1080/10570310500034196
Doyle C., & Goldingay S. (2012). The rise of the 'silver surfer': Online social networking and social inclusion for older adults. Journal of Social Inclusion, 3, 40 - 64.
Farrell J., & Belza B. (2012). Are older patients comfortable discussing sexual health with nurses? Nursing Research, 61, 51 - 57. 10.1097/NNR.0b013e31823a8600
Fitzwater E.L., & Puchta C. (2010). Elder abuse and financial exploitation: Unlawful and just plain awful! Journal of Gerontological Nursing, 36 (12), 3 - 5. 10.3928/00989134-20101102-02 21117550
Gatto S.L., & Tak S.H. (2008). Computer, Internet, and e-mail use among older adults: Benefits and barriers. Educational Gerontology, 34, 800 - 811. 10.1080/03601270802243697
Gott M., & Hinchliff S., & Galena E. (2004). General practitioner attitudes to discussing sexual health issues with older people. Social Science & Medicine, 58, 2093 - 2103. 10.1016/j.socscimed.2003.08.025
Heinz M., & Martin P., & Margrett J.A., & Yearns M., & Franke W., & Yang H., & Chang C.K. (2013). Perceptions of technology among older adults. Journal of Gerontological Nursing, 39 (1), 42 - 52. 10.3928/00989134-20121204-04
Jonson H., & Siverskog A. (2012). Turning vinegar into wine: Humorous self-presentations among older GLBTQ online daters. Journal of Aging Studies, 26, 55 - 64. 10.1016/j.jaging.2011.07.003
Lawson H.M., & Leck K. (2006). Dynamics of Internet dating. Social Science Computer Review, 24, 189 - 208. 10.1177/0894439305283402
Malta S. (2007). Love actually! Older adults and their romantic Internet relationships. Australian Journal of Emerging Technologies and Society, 5, 84 - 102.
Malta S., & Farquharson K. (2014). The initiation and progression of late-life romantic relationships. Journal of Sociology, 50, 237 - 251. 10.1177/1440783312442254
McIntosh W.D., & Locker L., & Briley K., & Ryan R., & Scott A.J. (2011). What do older adults seek in their potential romantic partners? Evidence from online personal ads. International Journal of Aging and Human Development, 72, 67 - 82. 10.2190/AG.72.1.d
McWilliams S., & Barrett A.E. (2014). Online dating in middle and later life: Gendered expectations and experiences. Journal of Family Issues, 35, 411 - 436. 10.1177/0192513X12468437
National Association of State Units on Aging. (2006). Late life domestic violence: What the Aging Network needs to know. Retrieved from http://www.ncea.aoa.gov/Resources/Publication/docs/nceaissuebrief.DVforagingnetwork.pdf
Poe S.S., & Costa L. (2012). Evidence appraisal: Research. In Dearholt S., & Dang D. (Eds.), Johns Hopkins nursing evidence-based practice: Model and guidelines (pp. 83 - 124). Indianapolis, IN : Sigma Theta Tau International.
Poole C., & Rietschlin J. (2012). Intimate partner victimization among adults aged 60 and older: An analysis of the 1999 and 2004 General Social Survey. Journal of Elder Abuse & Neglect, 24, 120 - 137. 10.1080/08946566.2011.646503
Qaseem A., & Snow V., & Shekelle P., & Hopkins R., & Owens D.K. (2009). Screening for HIV in health care settings: A guidance statement from the American College of Physicians and HIV Medicine Association. Annals of Internal Medicine, 150, 125 - 131. 10.7326/0003-4819-150-2-200901200-00300
Sassler S. (2010). Partnering across the life course: Sex, relationships, and mate selection. Journal of Marriage and Family, 72, 557 - 575. 10.1111/j.1741-3737.2010.00718.x 22822268 3399251
Schwartz P. (2011). 8 ways to find love online. Retrieved from http://www.aarp.org/relationships/love-sex/info-07-2011/online-dating-tips.html
Smith A., & Duggan M. (2013). Online dating & relationships. Retrieved from http://www.pewinternet.org/files/old-media/Files/Reports/2013/PIP_Online%20Dating%202013.pdf
Sum S., & Mathews R.M., & Pourghasem M., & Hughes I. (2009). Internet use as a predictor of sense of community in older people. CyberPsychology & Behavior, 12, 235 - 239. 10.1089/cpb.2008.0150
VandeWeerd C., & Corvin J., & Coulter M., & Perkins E., & Telford R., & Yalcin A., & Yegidis B. (2014). A preliminary investigation of risks for adverse outcomes of relationship seeking on social network sites (SNS): A descriptive study of women over 50 seeking relationships on MySpace in Hillsborough County, Florida. Journal of Women & Aging, 26, 127 - 145. 10.1080/08952841.2014.884897
Wallace M.A. (2008). Assessment of sexual health in older adults: Using the PLISSIT model to talk about sex. American Journal of Nursing, 108, 52 - 60. 10.1097/01.NAJ.0000325647.63678.b9
Whitty M.T. (2013). The Scammers Persuasive Techniques Model: Development of a state model to explain the online dating romance scam. British Journal of Criminology, 53, 665 - 684. 10.1093/bjc/azt009
Whitty M.T., & Buchanan T. (2012). The online romance scam: A serious cybercrime. Cyberpsychology, Behavior, and Social Networking, 15, 181 - 183. 10.1089/cyber.2011.0352
Zickuhr K., & Madden M. (2012). Older adults and Internet use: For the first time, half of adults age 65 and older are online. Retrieved from http://www.sainetz.at/dokumente/Older_adults_and_internet_use_2012.pdf
Copyright 2015, SLACK Incorporated