Dementia, Sexuality, and Relationships
According to the Alzheimer’s Association, disorders grouped under the general term dementia are caused by abnormal brain changes. These changes can cause a decline in cognitive abilities, memory, and behavior. Chances are, you probably know someone with a form of dementia. In fact, nearly 50 million people worldwide live with a type of dementia, with 10 million new cases being diagnosed each year. There are many types of dementia, such as Lewy body dementia, vascular dementia, and the most common type, Alzheimer’s disease, which accounts for nearly 70% of all dementia cases. Dementia cases are most commonly diagnosed in older adults, aged 65 and above, who exhibit common signs and symptoms. While dementia symptoms can appear differently in each adult, there are some signs that are reported often.
It’s not uncommon for partners, spouses and close friends, and family members to recognize signs and symptoms of dementia in their loved ones first. According to the Mayo Clinic, common signs can include memory loss, difficulty communicating or recalling commonly used words, difficulty making decisions, problem-solving, planning, and organizing. While most of these symptoms and behavioral changes are commonly discussed and widely recognized, there are some changes that can go unidentified—sexuality is one of these. As the disease progresses and changes in the brain continue to develop, many people with dementia can experience changes in their sexuality and sexual feelings.
Dementia’s Effect on Intimacy and Sexuality
As humans, we all have needs for friendship, companionship, and intimacy. These needs do not go away with a dementia diagnosis. However, as the disease progresses, the way the need for intimacy is expressed can change. In addition to the disease itself, other related conditions such as depression, medications, and changes in memory can result in behavioral changes that can affect one’s sense of sexuality. Some dementia-related changes in sexuality one might experience can include the following:
• Reduced sexual energy. Depression and anxiety are common side effects of dementia and can cause a decrease in sexual desire or the need for intimacy and friendship. Even if a person is not diagnosed with depression, withdrawing from people is common. While some people feel comfortable with this change in desire, others may enjoy being hugged, cuddled, and shown affection.
• Dementia and sexually inappropriate behaviors. Dementia can affect the areas of the brain that keep us from acting on our impulses. That’s why some dementia patients exhibit inappropriate sexual behaviors, such as flirting with strangers or speaking about sex in an inappropriate setting.
• Dementia and romantic relationships. While some people with dementia experience a decrease in sexual energy, others may feel an increased need for sex and other forms of intimacy. Knowing how to navigate this change can be difficult for many partners. One partner may feel a rise in sexual energy while their partner or spouse feels unsure of the new demand. If this new sexual energy feels uncomfortable, it can be helpful to explore other ways of feeling intimate.
• Hypersexuality. According to the Alzheimer’s Society of Canada, “As the ability to remember sexual interactions decreases, a person’s desire for sexual intercourse can increase.” This person might become overly interested in sex and masturbation. As the National Institute on Aging reports, these behaviors are related to the disease and don’t always mean that the person is interested in sex.
Issues to Consider
Navigating conversations around sexuality can be difficult, especially when dementia plays a role. It’s important to take all factors into consideration before starting a conversation about sex with your partner. Some people might misinterpret actions from people with dementia as sexualized behaviors. However, sexual behavior can be used as a way to communicate other needs of people with the disease. In fact, according to the Alzheimer’s Society, other reasons for behavior that may seem sexual can include needing to use the toilet, discomfort in clothing or temperature, boredom, expressing a need for affection, and mistaking someone for their own partner.
It’s also important to consider that people with dementia can continue to have a healthy intimate life, but what that looks like may change many times throughout the progression of the disease. Consistently readdressing comfort levels and desires will help both people in the relationship identify each other’s wishes and concerns. It’s common for both partners to change their wishes. In fact, some partners feel guilty if they no longer want to be intimate, while others may continue to have intimate moments.
Tips for Coping
Dementia can be a lonely disease. Most people living with dementia need to feel love and show affection consistently. It’s important to remember that the changes in sexual behavior you see in someone with dementia are products of the disease, not the person. While experiencing these changes in someone you love can be difficult, finding ways to cope can help.
• Explore ways to spend time together, like making lunch or dinner together, walking outside, or listening to music.
• Find other ways to show affection. If one or both of you are uncomfortable with being sexually intimate, you might consider hugging, holding hands, dancing, or sitting close to one another.
• Remember to be sensitive and reassuring. Navigating these changes is difficult, and judgment can make it worse.
• Do not feel guilty if you no longer feel romantically connected to your partner.
• Join a support group through the Alzheimer’s Association. There are groups in most geographical areas that can be accessed online.
• Do what feels best for you. Be gentle with yourself.
Living with Dementia at Inspīr
Navigating diseases like dementia can be difficult, but our special Oceana Memory Program and working with our Integrated Care Team (ICT) can make it easier. Designed for individuals with dementia or other cognitive impairments, Oceana offers personalized wellness lifestyle programming, customized care plans, and a highly trained staff, all in a therapeutic and secure setting. Our evidence-based approach to memory care is integrative, intentional, interdisciplinary, intimate, and individualized, enabling our residents to get the most out of every moment, every day.