The subject of intimacy can be an uncomfortable one for individuals with dementia and their caregivers alike. Factor in ongoing changes to sexual feelings and behaviors caused by Alzheimer's disease and other forms of dementia, and the challenges become even greater. Let's take a closer look at common intimacy-related dilemmas faced by caregivers (including spouses) along with highlighting coping and management techniques.
Human touch is important -- at any age.
Sexuality and Dementia
Feelings related to sexuality and dementia differ from person to person. In some instances, spouses or partners of people with Alzheimer's disease may not feel like it's acceptable to have sex with their loved one. In other cases, caregivers and care receivers alike may lose interest in sex and/or feel disconnected from each other.
Conversely, individuals with Alzheimer's and dementia may also develop an unnaturally strong interest in sex known as hypersexuality. This can manifest in a number of different ways, including through frequent masturbation as well as in the form of inappropriate sexual overtures toward partners, caregivers and others. While it's possible to manage hypersexuality by addressing underlying emotional needs, medication may also be used.
As dementia progresses, individuals may experience changes in the brain causing new sexual behaviors, such as increased desire, loss of inhibition, agitation and the inability to recognize sexual partners or even themselves due to memory loss.
The Intimacy Imperative
While dementia brings changes, it doesn't negate an individual's need for human affection, touch, and intimacy. Caregivers can fulfill these needs in other ways, such as through other displays of affection, including hand holding and cuddling; exploring nonsexual types of physical closeness, including dancing, hugging and massage; and spending quality time together in other meaningful ways, such as sharing a meal, seeing a movie, or just reminiscing about days gone by.
It's also important for everyone to remember that these irregular behaviors are not personal, but rather, symptoms of a disease. Feelings of frustration, sadness and grief are both normal and natural. Talking with a trusted peer, counselor, or member of the clergy can be useful in sorting through conflicted emotions.
If a decrease in sexual desire, hypersexuality, or other sexual issue is detrimentally impacting quality of life for care receivers, caregivers, or other family members, a doctor can offer helpful partnership -- particularly where other underlying medical causes exist.
Even a hug can go a long way toward supporting intimacy.
One last thing to keep in mind: As dementia progresses, the needs and expectations of both caregivers and care receivers may continue to change, meaning that what works today may no longer suffice tomorrow.
While the fact that every individual and situation is different means that there's no clear prescription for how best to manage caring for or being in an intimate relationship with someone with dementia, experts recommend adopting the most livable and pragmatic outlook. Approach these changes with an open mind, loving heart, and keen understanding of the role dementia may play in an individual's sexual attitudes and behaviors.
The podcast, "A Caregiver's Approach to Sex, Dementia and Intimacy" and mmLearn's caregiver training video, "Sexuality and Aging," offer more information for caregivers dealing with sexuality and intimacy issue.
Additionally, mmLearn.org hosts a large library of free videos for caregivers of older adults, covering a broad spectrum of topics pertaining to senior care. Whether you are a healthcare professional or a family caregiver, if you are caring for an older adult we know that you will find mmLearn.org an essential learning and guidance tool for all of your caregiver training needs. We welcome you to access our free online database of comprehensive videos for caregivers.