TWO senior citizens are sitting in the old people's home, discussing their sex lives.

Bill asks Bob: "Can you still do it?"

Bob: "Oh, yes, I do it almost every night of the week."

"Almost every night?"

"Yeah! Almost Monday, almost Tuesday, almost Wednesday …"

MARY turns to Jim: "Happy 75th birthday, darling. Let's go upstairs and make love."

Jim replies: "Pick one. I can't do both."

IF YOU chuckled at these jokes you wouldn't be alone. If you cringed at the idea of old people having sex, you most certainly wouldn't be alone. Older people as sexual beings may well be one of the last - and hardest to dispel - taboos in developed society.

Walk into your local newsagent and you'll find any number of greeting cards that lampoon the ageing process and the concept of older people having sex. Older people are presented as wrinkled and saggy, desperate and past it, pervy, decrepit or addicted to Viagra.

Satirising old age, it seems, is part of life, and certainly part of the vernacular. Phrases like ''you're over the hill'', ''he's an old fart'' or ''she's mutton dressed as lamb'' are a common part of Australian parlance and barely raise an eyebrow in general conversation.

But substitute a black, Asian, gay or disabled person as the subject of the joke and it becomes inappropriate to laugh. Why, then, is ageism tolerated in our society?

Researchers from the Australian Centre for Evidence Based Aged Care at La Trobe University (ACEBAC) say ageism can be connected to a fear of death. It also reflects our entrenched value system that focuses on productivity. Also, sexual attractiveness is associated with youth and beauty, so the inverse assumption is that older people are asexual and undesirable.

But the opposite is true, say advocates such as Rhonda Nay, a baby boomer and a refreshingly plain-speaking professor of interdisciplinary aged care.

"We have this perception that the only people who are sexually active are the hourglass women and the six-pack men. But when you look around, very few of us actually fit that description, but we're all having children and getting together," Nay says.

People of all ages, including older people, have sexual desires and are sexually active, most people masturbate and it's time we all got used to these ideas and started to talk about them, she says.

She says it's time for older people to "come out of the closet" as sexual beings, just as victims of homophobic prejudice have fought to achieve visibility and equality.

In an article Nay co-wrote for the International Journal of Older People Nursing, she described a future where older people have seized their sexual rights: "It's the year 2025 and the baby boomers have pioneered the revolution! Individual agency and resistance by older people to the asexual stereotyping have been successful.

''They realised that while they collaborated in the secrecy the stereotyping would continue and those 'oldies' who did dare to 'come out' were being stigmatised … A courageous few are always required to confront discrimination and start the change in attitudes and behaviours."

Jenny Jockhurst *, also a baby boomer, agrees that the time is nigh for older people to "make their own story" when it comes to their sexuality. Jockhurst, a consumer advocate who lives in regional New South Wales, cared for her husband, Mick, for 15 years as he battled younger-onset dementia. He died in 2010, when he was in his late 60s, after 35 years of marriage.

Jockhurst says that watching her ''very handsome'' and athletic husband succumb to the disease made her understand that a person's need for intimacy never changes, no matter what their age or physical state.

"It was about halfway through that his capacity to be himself [sexually] changed, that our relationship was no longer as it had been, and his needs had to be addressed differently. But his needs never changed: his intrinsic need as the person he was, for a demonstration of love and acceptance and warmth, that never changed until the day he died."

Jockhurst says reading Hugh Mackay's book, What Makes us Tick, articulated for her that people never lose their desires entirely.

"There's a drive that remains with us until we end our days. Older people and people with dementia don't lose the essence of the person they are. Anyone who knows them knows the essence of the person is there right to the very end," Jockhurst says.

She says that although her husband's decline was gradual, it was sometimes difficult for them both to adapt to the change to their sex life. "Certainly you do for a long time grieve the loss of the things that have been so special between the two of you and have given you immense joy and fulfilment; you are losing those things and don't have them in the same way any more.

''You can't replace those things, but people have to make their choices around that - your intrinsic needs don't change, but it's how you're going to satisfy them." She says there are a lot of people "not living the fullest, most normal, emotionally healthy life you'd advocate for".

Towards the end of his life, Mick was unable to lift his arms, so Jockhurst would place them around her so he could hold her, while she lay close to him. "I would spend ages cleaning his hands and his fingernails and rubbing cream into his arms. That lovely gentle touch and contact and closeness was lovely for him. It was immeasurably good for him in the absence of more usual ways to have that closeness."

For the majority of his illness, Mick was cared for at home, enabling him and Jockhurst to create their own framework for intimacy. For older people in residential care, however, the challenges surrounding sexual expression for both those who are of sound mind and people suffering a mental or physical disability can be difficult - for residents, their families and staff.

Catherine Barrett, a research fellow at La Trobe University's Australian Research Centre in Sex, Health and Society, began her career as a nurse in residential aged care. She says when she began working in the industry it was impossible to get people to talk about the sexual needs of residents, but as staff were encouraged to respond positively to the issue she saw an improvement to the quality of care, and therefore to residents' lives.

"Without education a lot of service providers will respond using their personal value judgments, but once you give them education and they get skilled at putting aside their own values and beliefs and saying what is best for the client, you find it's less of a problem."

One former aged care facility manager, who declined to be identified, recalls two carers walking in on an older man and woman in a room - "he with his pants down around his ankles and she with her knickers around her knees". He laughs and says: "The carers were a bit taken aback, and I said, 'Well, did you knock on the door?'

"You have to accept that people don't change because they're older. Their sex drive and need for companionship don't necessarily change. You get a few carers who are prim and proper, saying, 'That's disgusting' - but that's wrong. That's where you need a good policy in place, and to talk to staff about how to handle it."

Barrett runs workshops for residential care providers and says the most important thing is to give staff permission to talk about sexuality. She says it is also crucial that they recognise that older people have the right to a sexual identity and life - it's not a privilege - and that the resident is the primary client, not the family.

The trickiest issue, Barrett says, surrounds consent, particularly for those with cognitive impairment, as carers and families try to determine whether the older person is able to apply reasoning to their own situation.

A paper published by a team from ACEBAC this month tackled this question, addressing the concern that a person with dementia, for example, is seen to need protection from his or her own impaired memory and judgment. But they were clear that such decisions go beyond cognition and rationality and that emotions are important.

"While philosophers have argued for centuries over the relative importance of reason and passion in decisions about morality, surely in debates surrounding sex and intimacy more than any other topic, the role of passion and sentiment must feature prominently."

The right to take risks is also inherent, says Nay, who believes that by eliminating risk you eliminate the person. She says that part of what makes us human is struggling, overcoming challenges and taking risks. Most of the time, if the family's and resident's views contradict, it is the family's wishes that are mistakenly followed.

"To simply go with the family is not correct; [the older person] has the right to take risks. The issue of consent is vexed; I may not be able to understand my giving away $3 million, but if you look at my face you can tell what's going on in this relationship."

Nay is in favour of having a guardian or arbitrator who can mediate and ensure that the resident's rights are being supported.

Jane Boag is the general manager of residential services at Benetas, which operates 11 residential facilities in Victoria, across a range of care levels. She says providers must tread a careful line between meeting their legal responsibilities, their duty of care to patients, and the wishes of the resident and their family.

Benetas has a ''diversity'' policy which staff are trained to adhere to, covering factors like a resident's cultural and spiritual background and sexual preferences. But the problems are rarely black and white, Boag says. "It might be fine to say that the person is happy, but if you've got a spouse who's turning up three times a week to visit and their partner is in a confused state and having a sexual relationship with another person, it becomes difficult."

Industry workers say that this type of scenario is not uncommon because residents form friendships and romantic attachments with people other than their partner. Last year Benetas employed a dementia adviser to work with staff and families to iron out problems as they occur, particularly around communication between the different parties.

For the children of older people, becoming aware that their parents have a sexual identity may be confronting and enough to send them into what Nay and others have called "nauseated denial". Such resistance is a common obstacle to ensuring an older person's rights are protected when they are living in care.

Ellen Skladzien, the national policy manager at Alzheimer's Australia, says: "For a long time children haven't thought about their parents as having a sexual identify. It can put them in quite a difficult situation because they have never conceptualised their parents in that way." Add to that a reluctance to talk about end-of-life care and discussions around sexualised behaviour become mired in embarrassment, denial and anger.

Not all sexual behaviour is necessarily synonymous with sexual desire. Barrett says it's about looking "above the belt" - at what might be missing from a person's life. In many cases the older person may have lost a long-term partner and gone from being touched or embraced regularly to not being touched affectionately at all. Jockhurst says: "Night time is lonely, and being in the bed on your own. It just seems cavernous."

Nay says: "Often when people are behaving in a sexually inappropriate way there are ways of reducing that behaviour that have nothing to do with sexual activity, be it intercourse or anything else. It might be about giving them a massage, someone spending more time with them or giving them a hug.

''You will often see situations where people are stripping and that's seen as inappropriate behaviour. That can be as simple as that they're too hot, they've got itching, excoriation under their breasts. It's a matter of saying, 'what is this person trying to tell me?'"

* Not her real name.

Julia May is a Melbourne journalist.

Twitter: @Juliamaybe