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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.