Disinhibition

Inhibitions are the self-control mechanisms we all have that stop us doing things that break the rules of our society.

If someone close to you has dementia, you might notice that they stop following these social rules and behave in a way that’s very out of character for them.

This is called disinhibition, and it can look like:

• rude, tactless or hurtful comments
• sexual comments or inappropriate flirting
• undressing in public places
• touching their genitals in public
• impulsive actions, like dangerous driving.

Causes of disinhibition

Every person with dementia reacts to things in their own way. This means there can be a variety of causes for disinhibition, including:

• changes in the brain caused by dementia, which can lead to disorientation, confusion about people’s identities, or memory loss
• something in the person’s environment
• feeling frustrated by a difficult task
• feeling uncomfortable, sick or unwell.

In turn, this can lead to disinhibited behaviours. For example:

• If they’re confused about where they are or what time of day it is, they might start undressing to prepare for a bath or bedtime.
• If they think someone is their partner, they might make sexual comments or touch them inappropriately.
• If they have memory loss, they might have forgotten where the toilet is or how to use it.
• If they’re too hot or their clothing is too tight, they might take off their clothes.
• If they have a urinary tract infection, they might touch their genitals.

What you can do

If your family member or friend is showing disinhibited behaviours, there are a few things you can try.

When the disinhibited behaviour is taking place, you can support them by:

• staying patient and calm, even if the behaviour is embarrassing or upsetting
• reassuring and comforting them. If it’s appropriate, offer plenty of physical contact, such as hugging, arm rubbing or hair stroking
• gently reminding them that the behaviour isn’t appropriate
• trying to distract them, giving them something else to do or taking them somewhere private.

Over the longer term, you can help to prevent or reduce disinhibition by:

• trying to understand the reason why it’s happening. This can help you to work out how to respond or find ways to prevent it from recurring
• visiting the doctor to check whether illness or medication might be having an impact
• checking that their clothes aren’t uncomfortable, too tight or too hot, and buying new clothes, such as pants without zips.

Disinhibition can be very upsetting for families and friends. Make sure you’re caring for yourself too—take regular breaks, rest, and plan time to do the things that support your own wellbeing.

It’s okay to take care of your own health and happiness. If you're struggling as someone who cares for a person with dementia, contact the free, confidential National Dementia Helpline on 1800 100 500, any time of the day or night, for information, advice and support.