This article describes the relationship between body image and self-concept, discusses responses to changes in body image secondary to disease and injury, and explores strategies for adjustment to alterations in body image. Sociopsychological aspects of body image form a complex framework by which an individual understands the self and perceives how he or she is understood by others. As body image, self-concept, identity, and ego are closely associated, a loss of or alteration in any one of these factors can have deleterious effects on the entire self. Rehabilitation professionals assume an important role in helping people adjust to and accept alterations in body image by facilitating the grieving process; addressing loss, anxiety, and depression; and empowering individuals to emphasize and use their assets.

Sexual behavior depends on biological and psychological factors. A gradual decline in interest and capacity may occur with advancing age. Sexual relationships have patterns that are influenced by prior degrees of sexual tension and outlet, physical and emotional status, and the mutual needs of the partners. In this article, the authors explore sexuality, psychosocial issues, and sexual capacities of elderly people, including issues of menopause and erectile dysfunction. The role of rehabilitation nurses in helping older adults understand and adjust to changes is addressed. Sexual counseling, already a part of rehabilitation nursing for younger patients, also should be provided for elderly patients. Nursing goals and strategies need to address identifying sexual problems and educating elderly rehabilitation patients about altered sexual needs and capacities. To do this, rehabilitation nurses must be knowledgeable about the physiology and sexual needs of older adults, be aware of myths about sexuality, and understand their own values and attitudes regarding sex and sexuality as well as the values and attitudes of individual patients.

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