The importance of 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 Dementia 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
- Consider all the possible reasons for the inappropriate behaviours. This could include needing to go to the toilet, discomfort or boredom
- Gently discourage inappropriate behaviours
- Try to remain focused on the person, not the behaviour
- Aim to distract the person if possible or redirect them to another activity
- Find ways to include different forms of touch in the everyday routine so that the person gets some physical contact - massage, holding hands and embracing are ways of continuing to provide loving touch
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.
Dementia Australia can link people to a large number of support groups throughout Australia. Many people find comfort and practical assistance by attending these meetings with others who know what it is like to care for a person with dementia. Support groups bring together families, carers and friends of people with dementia under the guidance of a group facilitator. The facilitator is usually a health professional or someone with first-hand experience of caring for a person with dementia.
Who can help?
Commonwealth Carelink Centres around Australia provide information about the range of community care programs and services available to help people stay in their own homes. Funded by the Australian Government, the Commonwealth Carelink Centres can advise you about what is available for you and the person you are caring for. Call 1800 052 222.