Alzheimer’s disease and other forms of dementia can have a profound impact on couple relationships. Emotional, physical and sexual intimacy are all impacted in one way or another by the brain changes that come with dementia.
The time you once spent together engaged in meaningful conversation, daily experiences and acts of love has now become a bit more difficult and strained.
Your partner may lose the ability to share in the hopes, plans and memories you once had together. You may be navigating the loss of the person you once knew. In addition, your partner’s behaviors (and even your own) toward sex and intimacy may change.
Discussing intimate physical and sexual acts is generally considered a taboo subject. By their very nature, these are private experiences shared between two people. Yet, as we age, it’s not unusual to have questions — especially when dementia is involved.
If you’re reading this and your partner has dementia, know that you aren’t alone. Read on to learn more about how dementia affects intimacy and sexual behavior and ways you can keep an intimate relationship with someone you love.
How does dementia affect intimacy and sexual desire?
Having dementia can affect how the brain works and change the way a person with dementia acts.
“The parts of the brain that are responsible for sexual desire, inhibitions and sexual behaviors can be impacted when someone has dementia,” said Michele Grigaitis-Reyes, a family nurse practitioner at Banner Alzheimer’s Institute in Phoenix, AZ. “These changes in the brain may result in behavioral changes, including how they express their need for intimacy.”
Because of this, intimate and sexual behavior may become more unpredictable and harder to understand as your partner’s dementia progresses. It’s important to understand that these behavioral changes are common and aren’t a reflection of the person with dementia but the disease.
Some of the changes you and your partner with dementia may experience include:
Having less sexual energy and desire
Your partner may have less sexual energy or interest. This may be more common if they are experiencing depression or taking new medications. With treatment of depression or adjustment of medications, sexual interest may return.
As the caregiver, you may experience changes as well. “Some caregivers may maintain sexual desire, some may lose desire and others may be too exhausted from caregiving to even think about intimacy or a sexual relationship,” Grigaitis-Reyes said. “It can be hard to be sexual when you’re acting as a caregiver.”
Having more sexual energy and interest
Dementia can also cause the opposite effect. Your partner with dementia may show an increased interest in sexual activity. Memory loss can result in them frequently forgetting they had sexual activity resulting in them frequently approaching you.
Saying or doing things in public they would previously have never done or done in private
Dementia can affect inhibitions. This means your partner may stop following the usual social rules about how to behave in public. Disinhibited behaviors can seem unusual, shocking and offensive.
Your partner’s actions may include flirting or making inappropriate comments to another person or making sexual or suggestive comments with other people. They could do personally intimate things that were once kept private, like taking off their clothes in front of others or touching themselves and masturbating in public.
If your partner with dementia is demonstrating behaviors that could be perceived as sexual, it could be the result of their disease, but it may also have other causes you should be aware of. These causes may be due to an infection, such as a UTI (urinary tract infection), or due to feelings of pain, discomfort or loneliness or confusion.
“Your partner may take off their clothes because they are unable to articulate they need to use the bathroom,” Grigaitis-Reyes said. “They may become disoriented and forget where they are or who they are with.”
How to respond to inappropriate behavior
“When disinhibited behaviors happen, it can be shocking,” Grigaitis-Reyes said. “Remember that these behaviors are related to how dementia affects the person and aren’t deliberate or intended to hurt you or anyone else.”
- Look for a reason behind the behavior. Is your partner uncomfortable? Do they need help?
- Try to respond with patience and don’t overact – even if their behavior is embarrassing.
- Distract and redirect the behavior. Lead them to a private place or try distraction with something else to do or fidget with.
- Use appropriate touch to ease their anxiety and provide reassurance. Stroke their hand. Give them a hug.
- Talk to their provider and see if the behavior change is due to an illness or other issue.
Tips for coping with changes in your relationship
All couples facing dementia will have to find new ways to nurture their relationship. It’s important to remember that the changes in sexual behavior you see in your partner with dementia are products of the disease and not them as a person.
While experiencing these changes is difficult, finding ways to cope can help. Grigaitis-Reyes shared the following tips to rekindle intimacy with your partner.
- Talk with your partner about intimacy and sex. Discuss with your partner as soon as the diagnosis is made and as dementia progresses. If your needs differ, having these open, honest conversations can help you find creative ways to meet each other’s needs.
- Explore ways to spend time together. If your partner has the capacity, this can include dancing, going for walks or car rides, playing cards and looking through photos together and reminiscing. Helping your partner shave or put on makeup can also be a very intimate activity. It can also be as simple as holding hands and watching the sunset or snuggling in bed together – even if for a few moments.
- Calendar sexual activity. Sexual activity and consent can be complicated when one partner has dementia, but a diagnosis of dementia doesn’t mean your partner automatically lacks mental capacity. However, they may forget they’ve had sex and become overly demanding. If your partner can consent but has amnestic, or significant memory loss, scheduling a sexual activity on a calendar can be very helpful. This will help you fulfill both your sexual desires and be an exciting reminder.
- Use the power of touch. Touch is a powerful tool that can convey reassurance, safety and compassion — especially when you can no longer engage in sexual activity. It can be as simple as a foot or hand massage, combing their hair or stroking their hand or cheek.
- Be sensitive and reassuring. Sometimes people with dementia are overly interested in sex. To cope, give the person more attention and reassurance. Gently touch, hug or use other kinds of affection to meet their emotional needs. Typically, when intimacy needs are met, those behaviors will diminish.
- Meet your own sexual needs. If you are unable to engage in sexual activity together, find healthy ways to fulfill your own sexual needs. For some, this is masturbation.
- Talk to your partner’s health care provider. Talk to your partner’s provider if your partner starts to exhibit changes in behavior so they can be addressed appropriately.
- Join a caregiver support group. No one understands this journey better than the people who walk it. You can find great benefit and comfort from listening to others who may have experienced what you have gone through and learning from their interventions and their strategies.
Fanning the flames of love and affection may be a bit more challenging when your partner has Alzheimer’s disease or another form of dementia. The disease can affect their memory but also can change their appetite for intimacy and sexual activity. Added to this, taking on the role of caregiver to your partner can be exhausting, lonely and longing for the relationship you once had.
Although dementia takes much from your loved one, there is still much left in them. The ways of expressing love and affection may change but love remains. Understanding dementia and making time for intimate moments can help you find new meaning in your relationship.
For more information and resources, contact the Banner Alzheimer’s Institute or visit Alzheimers.gov.