Shifting focus: Guide to understanding dementia behaviour
This booklet is meant to help family members, friends and caregivers of people with dementia understand behaviours and actions.
It provides information about the following:
- Brain and dementia
- Recognizing and understanding the person’s actions and behaviours
- Supportive strategies
For more information, check out our brochure, Conversations About Intimacy and Sexuality.
Interest in sex does not decrease as we age, even when a person has dementia. In some cases, their actions will be interpreted as sexual when they are trying to communicate. When behaviour expresses a sexual desire, give them privacy. They are an adult and have the right to be left alone.
Sexual behaviour involving a couple (when one or both has dementia) is a difficult subject, especially if not with a spouse. While it may be tempting to try to stop the relationship, keep in mind they likely no longer remembers their partner or even being married. Allowing it to continue may hurt their spouse and family, but further responsive behaviour may occur if he is either prevented from seeing his new companion or made to feel guilty. Distraction can work to disengage the behaviour, at least for a period of time.
Please keep in mind that this refers to consensual behaviour. If the sexual behaviour is not consensual (e.g. resident to resident or resident to staff member), use the strategies below.
- Less control over urges due to changes in the brain
- Disrobing because of tight clothing, an overheated room, the need to use the washroom or disorientation of time and space
Tips and strategies
- Provide privacy.
- Stay calm and don’t judge or scold.
- Distract with activities that suggest comfort (cuddling a pet or stuffed animal or looking at family photos) or keep hands busy (folding, sorting or holding stress balls).
- Change his wardrobe with shirts that close in the back or provide suspenders if he takes off his pants.
- If she makes sexual advances on a visitor or co-resident, try to distract her or remove her from the situation.
- Avoid approaching him in ways that might be misunderstood (i.e. stroking his knee or putting your arm around his waist).
- Gently touch or hug the person in a way that will not be perceived as sexual.
- Offer a body pillow to cuddle in bed (if the person goes into other people’s beds at night). A stuffed animal or a hot-water bottle wrapped in a towel can also provide comfort and satisfy the need for a warm body.
- Put a pillow on his lap for a barrier between his hands and genitals.
- Contact staff immediately if your physical well-being is in danger.
- Provide her with an apron to wear with pockets full of objects to touch. This might divert her from touching herself or at least allow her to do so more discreetly.
More useful links and resources
Conversations about dementia, intimacy and sexuality. Alzheimer Society of Canada. In this information sheet, learn how dementia can affect a person's sexual behaviour and desire for intimacy, and get strategies to help people living with dementia, caregivers and healthcare providers have conversations about intimacy and sexuality.
It’s time to end the taboo of sex and intimacy in care homes. The Conversation, April 2017. This article summarizes a study on sexuality and intimacy in care homes, and highlights the need for more awareness around these topics, particularly through the lens of of black, working-class and LGBT individuals.
Inclusive services for LGBT older adults: A practical guide to creating welcoming agencies. National Resource Center on LGBT Aging, 2020. This resource guide provides best practices to organizations interested in serving LGBT older adults better.