Intimacy and sexual issues
This page discusses intimacy and sexual issues for people with dementia, their families and carers. It describes the importance of these issues in their lives and ways to deal with some of the problems that may arise.
Intimacy and sexuality The need for closeness is a very important and natural part of our lives. Intimacy is the giving and receiving of love and affection. It involves caring touch, empathic understanding, comfort in times of need and a feeling of safety in relationships.
Sexuality is the feeling of sexual desire, which is expressed through sexual activity. Like intimacy, sexuality is a natural expression of human need. However, for many people sexuality goes beyond the narrow concept of sexual intercourse, and is bound up with many of the broader expressions of intimacy such as physical closeness, kissing and hugging.
How are intimacy and sexuality affected by dementia? People with dementia continue to need loving, safe relationships and caring touch. However they will vary in their individual ways of giving and receiving affection, and the ways in which the dementia affects that capacity. As a result of the disease, some people with dementia may become demanding and insensitive to the needs of others, and less able to provide caring support for their family and friends. They may also experience changes in the expression of their sexuality. Some people continue to desire sexual contact while others may lose interest in sexual activity. Others may display inappropriate sexual behaviours.
Partners may experience a range of feelings about continuing a sexual relationship with someone who has dementia. These may include feelings of rejection, distaste and guilt. It can be helpful to discuss these with a professional. Your doctor may be able to help, or contact Alzheimer’s Australia to arrange to speak to a counsellor. Discussions with doctors and counsellors are confidential. To find out more, contact us or call the National Dementia Helpline on 1800 100 500.
Changed sexual behaviours
It is important to remember that any strange or uncharacteristic behaviour is part of the illness and not directed in a personal way. A person with dementia may no longer know what to do with sexual desire or when or where to appropriately exercise the desire.
Increased sexual demands
Some partners find that a person’s desire for sexual activity increases which may result in unreasonable and exhausting demands, often at odd times or in inappropriate places. Occasionally aggression may be shown if needs are not met. You may have to stay safely out of the way until there is a mood change. Some partners complain of feeling like an object. Once the person with dementia has had sex, they may forget immediately what has occurred.
Diminishing sexual interest
Many people with dementia lose interest in a physical relationship and may become very withdrawn. They may accept physical contact from others, but not initiate affection. Partners can feel hurt and bewildered by the loss of interest.
Loss of inhibitions
People with dementia sometimes lose inhibitions and make advances to others or undress or fondle themselves in public. Sexual advances are sometimes made because the person with dementia mistakes another for their partner. Sometimes something that appears sexual, such as a woman lifting her skirt, may be an indication of something else, such as the need to go to the toilet.
Managing inappropriate sexual behaviours: What to try
Like all the challenges faced by families and carers of people with dementia, discussing this with an understanding person can help. Support and affection from friends and family can help you cope with the situation. Talking about problems in a support group can help. Knowing that others have been through a similar experience may assist you to feel that you are not on your own.
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