Dementia does not change the need for love and affection. It can, however, affect a person’s interest in sex, either increasing or decreasing it. Dementia can also change the person’s ability to understand what is appropriate behaviour when in the company of others. For example, if the person with dementia seems to be rubbing his genitals, it might be because he needs to go to the bathroom or because his clothing is too tight. He may even have a genital or urinary infection.
If the problem is with a person trying to undress when it is not appropriate, there may be a good reason, such as being too warm, trying to get ready for bed (even if it is not time for bed) or the clothing may not be comfortable.
Dementia changes how people see things. A person with dementia may forget that behaviour with potential sexual overtones in public is not acceptable.
Tips for dealing with changes in sexual behaviour
Here are some tips to respond to behaviours that are occurring at inappropriate times or in inappropriate ways:
- Stay calm. Do not blow the situation out of proportion. The person with dementia probably does not understand why there is a problem. Remember that she has less control over her needs and urges due to changes in the brain.
- Ignore the behaviour, if it is appropriate to do so.
- Distract or redirect the person with an activity. For example, a person with dementia who is bored or under-stimulated might masturbate as a distraction.
- If sexuality is becoming an intense interest (due to changes in the brain), redirect the sexual energy of the person with dementia with an activity such as going for a walk. If he is constantly initiating sexual advances even after a sexual encounter, reassure him that you just had a lovely time together and propose going to an environment that is not intimate (such as a public place).
- Provide privacy for the person if she is in a public area.
- Leave the situation, if appropriate. Take a break and come back later.
- Give the person with dementia something to hold or manipulate, if the person with dementia is acting in a way that is making others uncomfortable. The person might have a need to manipulate things, or may just be bored.
- Comfort the person. She might be anxious or fearful and may be using sexual outlets as a way to get comfort and feel more secure.
- Gently touch or hug the person in a way that will not be perceived as sexual. What we perceive as a sexual behaviour might be an attempt to connect, or give or display affection.
- 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 to feel a warm body; a pet lying at the foot of the bed can also provide companionship.
- Adapt the environment to the situation. It is often easier to change something in the environment than it is to change the behaviour of the person with dementia. For example:
- If someone is exposing his genitals, consider pants with no zipper, pants with suspenders, or overalls.
- Wearing an apron with pockets filled with interesting objects to touch might divert someone from touching herself or at least allow her to do so more discreetly.
- Putting a pillow on someone’s lap can provide a barrier between his hands and his genitals.
- Wearing an athletic cup might prevent a man from grabbing his genitals.
- Do not take it personally. You are not responsible for the behaviour of the person with dementia. The behaviour comes from the illness and is not a reflection on you.
- Consult your physician. Side effects of some medications will lower sexual desire or cause impotency (inability to have an erection). If your partner with dementia is becoming aggressive in his sexual relationship with you, and if non-medical interventions are ineffective, consider talking to your physician, who might prescribe medications to decrease the libido (sex drive).
- Check for signs of depression. People suffering from depression often lose interest in sexual intimacy.