Intimacy and sexuality

The need for closeness is an important and natural part of our lives.

Intimacy is the giving and receiving of love and affection. It involves caring touch, empathic understanding and feelings of comfort and safety in relationships.

Sexual expression is the feeling of sexual desire and can be expressed through sexual activity. Like intimacy, sexual expression is a natural expression of human need. Sexual expression includes intercourse, physical closeness, intimate touch, kissing and hugging.

How intimacy and sexual expression are affected by dementia

People with dementia continue to need loving, safe relationships and caring touch. However, they will have individual ways of expressing and receiving affection.

You may notice changes in intimate and sexual expression. The person living with dementia may:

  • be less able to provide caring support for their family and friends
  • seem demanding or insensitive to others’ needs
  • feel more, or less need for sexual expression and intimacy
  • have difficulty in physically coordinating sexual intimacy
  • display sexual behaviours in inappropriate social contexts.

Communication

Dementia can affect someone’s sexual feelings and behaviour over time.

The person living with dementia may feel uncertain, frustrated or a loss of confidence. This can lead to changes in their feelings towards their partner.

There might be things they cannot do any more.

If possible, talking openly about sexual changes may help you both stay close. It can also lead to less confusion, blame, resentment, guilt or lowering of self-esteem.

Discuss your needs and expectations for now, and in the future. It is important to allow your partner to do the same. You may need to make changes to find sexual contact or activities that you both enjoy.

Explore new methods of intimacy such as sexual and non-sexual touching, or perhaps sharing special memories or music together. Partners can work together to find something that satisfies them both.

Changed sexual behaviours

It is important to remember that any changed or uncharacteristic behaviour is part of the condition. A person with dementia may no longer know what to do with sexual desire or when or where to appropriately exercise it.

Increased sexual demands

Some people living with dementia have an increased desire for sexual activity which may result in changed behaviours and exhausting demands, often at unexpected times or in inappropriate places. Occasionally aggression may be shown by the person if their needs are not met.

Some partners say they can feel like an object, because once the person with dementia has had sex, they may immediately forget what has occurred.

It can be helpful to discuss your feelings with a professional. Your doctor may be able to help, or contact Dementia Australia to speak confidentially to a counsellor.

Diminishing sexual interest

Many people with dementia lose interest in a physical relationship and may become withdrawn. They may accept physical contact from others, but not initiate affection. Partners can feel hurt and bewildered by the loss of interest.

Depression can lead to a loss of interest in sex. Some medications can have side effects that change a person’s sexual desire. As a person’s dementia progresses, they may feel more, or less need for sexual expression and intimacy. Speak to a doctor or counsellor if any of these changes cause physical or emotional distress.

Loss of inhibitions

People with dementia sometimes lose their 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 person for their partner.

Sometimes behaviour that may appear sexual (such as someone lifting their skirt), may be an indication of something else, such as the need to go to the toilet.

Responding to inappropriate sexual behaviour

Consider possible reasons for the behaviour. These could include needing to go to the toilet, discomfort or boredom.

What to try:

  • Gently discourage inappropriate behaviour.
  • Try to remain focused on the person, not the behaviour.
  • Try not to shame the person or create an issue. Communicate using a normal tone and language.
  • If possible, aim to redirect the person to another activity.
  • Provide opportunities for appropriate sexual expression in private, either together or individually.
  • Find ways to include different forms of touch in the everyday routine to maintain physical contact, such as holding hands, hugging and massage.
  • Exercise and use physical energy in ways that make the person feel valued.
  • Listen to favourite music, reminisce and engage in other favourite activities.

A partner’s sexual needs

If someone living with dementia has a reduced sexual interest, their partner may want to find ways to explore their own sexual needs without engaging the person with dementia.

As a partner’s caring role increases, they may experience changes in their own sexual interest in the person living with dementia.

The partner who is a carer may reduce their sexual engagement with the person living with dementia, or no longer desire sexual engagement with them.

Get support

  • Talk with other people. This can support you, so you do not feel you are on your own. You might want to talk with an understanding friend or family member who can provide support and affection.
  • Join a support group. Support groups bring together families, carers and friends of people with dementia, to share knowledge, tips and strategies with others going through a similar experience. Often, groups are led by a health professional or someone with first-hand experience of caring for someone with dementia. Many organisations throughout Australia offer support groups for carers, in person and online.

Where to get help?