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Seniors, Sex & Dementia: Managing Inappropriate Behavior

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July 1, 2015

Senior sexuality represents possibly the last remaining taboo. No one wants to talk about it. In a 2013 survey conducted by Home Instead, Inc., fewer than one-third of adult children said they were even the slightest bit comfortable talking to their parents about senior sex.

And that’s a problem, because certain medical conditions—like dementia and Alzheimer’s disease—can cause seniors to engage in inappropriate sexual behavior. This development can be disturbing for adult children and caregivers alike, and it can be difficult to manage. As a senior care professional, you can help your clients address these behaviors by sharing some tips and resources.

Defining Inappropriate Sexual Behavior

Let’s be clear about one thing: not all sexual behavior by seniors is “inappropriate.” Many seniors enjoy healthy sex lives well into older age. A study by the New England Journal of Medicine found 25 percent of seniors over age 75 are having sex, and about 50 percent of those between ages 65 and 75 are also sexually active.

No matter the age of the adult participants, consensual sexual behaviors can be considered normal and healthy—as long as the participants retain the cognitive ability to consent.

When Sexual Behavior Becomes Inappropriate

Unfortunately, cognitive decline can cause seniors to engage in inappropriate sexual behaviors outside of a loving relationship or in unsuitable environments. These behaviors can cause distress for family members and caregivers who may feel ill-equipped to deal with them.

Let’s look at three common situations and how to cope with them.

1. Masturbating in public

“My father had vascular dementia. He started masturbating in public. Of course, I was appalled when I was told this and then I witnessed it. (I guess a part of me was hoping that I was being told incorrect info.)”

So begins the story of an anonymous family caregiver in the Alzheimer’s Reflections community.

If a family caregiver asks you for guidance regarding a senior loved one who is fondling himself in public, you might advise them to start with a medical examination. In seniors who can’t communicate well, public masturbation may signal a medical issue, such as pain or a urinary tract infection. These medical causes may be ruled out (or treated) with a physical exam conducted by a skilled geriatric practitioner.

In our anonymous family caregiver’s case, a trip to the doctor did the trick. She said, “I involved his MD, who examined him, and then gave him a low dose of an anti-depressant medicine. The behavior stopped.”

2. Inappropriate or unwelcome touching of others

“My mom seems to have a problem sometimes. My hubby will give her a hug as he always has. But occasionally she puts her hands where they shouldn't be. So hubby tries to avoid her… which confuses her when she wants that hug.”

Sexual inappropriateness with dementia certainly is not limited to men. As this comment illustrates, women can develop wandering hands, too.

One way to cope with wandering hands during embraces is to develop a new way to hug. Follow these steps:

  • As you approach the senior, stop a short distance away and raise both hands in front of you in a “stop”-like gesture. Smile and make eye contact.
  • Verbally encourage the senior to raise her hands in the same position.
  • Move forward and place your palms against hers. Quickly interlace your fingers to hold onto her hands.
  • Now that the senior’s hands are secured, you can guide their hands toward your shoulders as you lean in for a ‘hug,’ to touch cheeks or to give your loved one a kiss.
  • When the embrace is finished, back away and release the senior’s hands.

This method allows seniors to enjoy the physical touch of family members while ensuring hands don’t inadvertently wander where they shouldn’t go.

3. Stripping in public

Because Alzheimer’s disease and related dementias reduce a person’s inhibitions, seniors with these conditions may not realize it’s inappropriate to take their clothes off in public. If a family member seeks your guidance on this issue, it’s important to point out this behavior may not be sexual in nature at all.

Seniors with dementia may disrobe in public for a variety of reasons, from feeling too warm to experiencing an urgent need to urinate. If family members can figure out what triggers the behavior, they may be able to resolve the underlying issue.

In the meantime, family members can manage the activity as it occurs. Advise them to always take a shawl or throw with them to cover their family member as the clothes come off. Help your clients find resources for clothing that is difficult to remove, such as items with fasteners in the back. Encourage family members to stay calm and not to shame their loved one. Be sure family members know their loved one cannot necessarily control this behavior.

Keep the Conversation Going

As a senior care professional, you have the opportunity to bring senior sexuality out into the open. While adult children report reluctance to talk about this subject, they seem to feel relieved when someone broaches the topic to them. As another member of the Alzheimer’s Reflections community put it:

“I have been a caregiver for the past 18 years. In all that time I have never had that issue come up. It actually had never even occurred to me! How awesome that you have brought this subject to the forefront for discussion if the need arises!”

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Thoughts and stories from others
  1. October 21, 2017 at 8:19 pm | Posted by Kim Anderson

    I am a caregiver for a 82 yr old Alzheimer's patient. I have been a caregiver for awhile now but never have come across a patient that is so sexually forward. He constantly is telling me how nice my breasts are, how nice my butt is and asking if I want to have sex. I always tell him it's not appropriate and I'm happily married. But of course 5 minutes later he is at it again because he can't remember. I can't stay away from him because of the level of care he needs. Anyone have these issues, and how to handle them? Right now it's just verbal, but I have to wonder what the future holds?


  2. October 13, 2017 at 12:08 pm | Posted by Anne-Marie Anasson

    My 84 year old husband who has vascular dementia becomes very rude and personal in the evening and has lost empathy. But at the same times he loves watching sexy young girls dancing on tv.


  3. October 13, 2017 at 11:46 am | Posted by Annemarie Anasson

    My 84 year old husband has developed an obsession at watching young sexy girls dancing and when he does he is very rude to me and tells me to leave him alone and leave the room. I feel hurt angry rejected and can’t believe he treats me this way after 59 years of marriage.


  4. October 13, 2017 at 11:43 am | Posted by Annemarie

    My 84 year old husband has developed an obsession at watching young sexy girls dancing and when he does he is very rude to me and tells me to leave him alone and leave the room. I feel hurt angry rejected and can’t believe he treats me this way after 59 years of marriage.


  5. September 21, 2017 at 4:20 pm | Posted by Rebecca

    Tears of RELIEF are streaming down my face. Yesterday my dad, who is at end stage heart failure with dementia, stuck his tounge in my mouth during a kiss and tried to do it again when mom left the room. ( Btw, my family are mouth kissers-always have been. But quick pecks.) I instantly felt sick and left soon there after.I searched for what you are all are sharing. Thank you for sharing your experiences. No more mouth pecks for him! I have decided not to tell my mom who I don't think would handle it well. I just have to make sure I'm not in a position where this can happen again.


  6. September 9, 2017 at 4:39 am | Posted by Liv Lindahl

    Having Alzheimer's doesn't mean that they are not capable of making ALL decisions. My grandmother is well into the final stages and I take care of her..she has good days and bad days and some decisions that she makes are completely rational. Why would you take a pleasure away from two people that both agree on wanting to do it when they suffer from a disease like Alzheimer's that can cause severe depression and most always causes them to not be able to have, little if any-of the joys they used to have. Why take the little bit of joy they are able to have away? Im sure they have lived a very long life of taking care of children and grandchildren, and I would say they most definitely earned it...and no matter how bad off they should always respect your elders.


  7. September 1, 2017 at 8:23 pm | Posted by Karen

    My 90 year old father with stage 3 dementia has started master bating a lot in the hall in front of me and his verbiage is. "I'm gonna jack off". He would never do this in front of me and then he doesn't remember my brother is his conservator and lives a state away he thinks it's just me. I think he needs to take care of dad or place him. I'm recently widowed and am very emotional over everything. Any ideas or advise would be most welcome. Ty


  8. July 30, 2017 at 12:56 pm | Posted by Rebecca Lou

    My 86 year old husband has ALZ and also wears a foley catheter because of bladder issues. He is in a group home and has recently discovered his sexual side when I visit. We had not had intercourse for over 2 1/2 years prior to his ALZ diagnosis because of his catheter. Now he is starting masturbating (so far, thankfully in his room at night), and I am worried that he will somehow disconnect his catheter tubing, and/or start making advances at his caregivers. He cannot take psychotropic type drugs and is very sensitive to any drugs that affect his nervous system. How can I redirect him when I'm not with him at night?


  9. July 24, 2017 at 8:51 pm | Posted by Bev

    I work at a assisted living facility, on alz unit. We have 2 residents that are having sex on a daily basis, our supervisor told family about it, and both residents family are ok with this as long as they are happy. My question is how is this ok, if neither resident can make other important decisions on there own?


  10. July 20, 2017 at 12:17 pm | Posted by Katelyn

    I've been working for an elderly man with Alzheimer's for 2 and a half years now. His behaviour has become more sexual and very inappropriate as time has passed. I know it's his disease, but it makes me feel very uncomfortable. He'll say things to me like "want to go in my room and make love?" Or "you have a nice bum lady" ( as he tries to reach for my ass and grab it). Sometimes he asks for a hug, which I used to comply and give him a hug, but now whenever he asks and I comply he tries to feel my ass and kiss my neck. I've had to stop the hugs completely now because even with me explaining to him why it is wrong, he just doesn't listen or understand. I've been having trouble dealing with his actions and words. Does anyone have some tips on how to better control him and potentially slow down those kinds of behaviour. I feel like I've tried everything.


    • August 8, 2017 at 11:03 am | Posted by Vu

      What's about giving him a hand shake instead of a hug? Encourage his family members giving him more hug to satisfy his desire of being loved & touch. I found a daily exercise like walking (until they are exhausted) would work too because they would physically think of just a nap or foods after that. Just a 2 cents but do hope it helps. A daughter of the dementia man.


    • August 8, 2017 at 11:07 am | Posted by Vu

      What's about giving him a hand shake instead of a hug? Encourage his family members giving him more hug to satisfy his desire of being loved & touch. I found a daily exercise like walking (until they are exhausted) would work too because they would physically think of just a nap or foods after that. Just a 2 cents but do hope it helps


  11. June 23, 2017 at 3:55 am | Posted by Lalola

    After returning home from dinner, my father with Alzheimer's suddenly out of the blue, leans over to me and within inches of my face, gives me a kiss on the lips and he says to me "thank you for being my friend". Thinking that was odd, I replied with "I'm not your friend, I'm your daughter!" He then replies with "You can leave that out and we can have fun!" That made me kinda ill, as I was molested as a child by a couple of relatives! I then said, "I needed to leave," " he says, why, I thought you were spending the night? then he gets up from his chair and gives me a big hug! Then tells me to call him when I get home! My 42 year old daughter is spending the weekend with him, to watch over him. I hope he doesn't do the same to her! I'm well aware it's his disease, but it still makes me very uncomfortable!


    • July 25, 2017 at 8:16 am | Posted by Wend

      I am so sorry this happened to you...but I have to admit I feel relieved reading it. My dad is 78 and has always been the most amazing parent - although he has not been diagnosed with Dementia (my mum refuses to accept it) he has started to display some very odd behaviour. Forgetful, aggressive (arguing with my mum a lot and reducing her to tears) Lots of other symtoms - asked me a couple of months ago for a "real kiss" completely out of the blue. He leaned in to kiss me. I was so shocked and upset. But since then he has made inappropriate comments and tried to touch/kiss me when he thinks no one else is looking. I am at my wits end. I feel like I don't want to visit my parents anymore which is heart breaking. I can tell my mum what is going on as she has a brain tumour and I know that knowledge will destroy her :(


  12. June 14, 2017 at 5:38 pm | Posted by Syl

    My daughter and I are caring for her father (we have been divorced for many years). He has Parkinsons and dementia. In 2 days he is moving into assisted living. It's a great place and he will still have his own apt. In the last month he has rediscovered is genitals and is maturbating every night. He takes strong meds for Parkinsons, anti depressant and anti anxiety. Clonazepam sleeping pills at night. We don't have a problem with his activity in his bedroom alone, but we monitor him with cameras, which you can understand how disturbing that his for our adult daughter to see. Then the other problem is that he is soooo active doing this which drains all his energy so the next day all his Parkinsons symptoms are debilitating. His neurologist was no help when we confided in him. Looking to change doctors...but in the mean time...what do we do? We pray this behavior is not going to go outside his new private apt.


  13. April 10, 2017 at 7:15 pm | Posted by Melissa May

    My father suffers from everything it seems, from C.O.P.D. to congestive heart failure, to needing kidney dialysis 3X a week. Sometimes he acts his version of "normal," but other times he randomly asks me to perform sexual acts or calls me a 'sexy thang,' NOT joking. It's startling, at the very least. Maybe he means it as a compliment, but I'm his caregiver and have to live with him, making it difficult with the occasional pervertedness. I know he's elderly, but I don't know why that would make him drop his inhibitions so low that he'd solicit his own daughter. I can't handle this much longer.


    • May 19, 2017 at 12:40 am | Posted by Barb

      Hi Melissa- I came across your post and wanted to reach out. My dad with Alzheimer's made a pass at me today (tried to touch me in a sexual way) and though I know it's the disease and not him (he was a good dad when he was well), I am still deeply disturbed. I can't get over the sick feeling.How are you dealing with your dad's inappropriate behavior? Is it still going on?I hope you're doing okay.


    • July 25, 2017 at 8:25 am | Posted by Wend

      Hi Melissa - your story is identical to mine. My dad has COPD and various other problems - he has always been an amazing parent and NEVER done anything untoward growing up. However out of the blue he asked for a "real kiss" now when I visit he makes inappropriate comments and advances towards me. It is so horrible it makes me feel disgusting. I am at my wits end. He has not done this to any other family members. I cant tell my mum as she has a brain tumour and I know it will destroy her. It just makes me want to stay away but they are both nearly 80. I am heart broken but disgusted.


  14. March 6, 2017 at 4:42 am | Posted by Nicole

    What do i do when a resident with dementia goes out of their way to molest another reaedent. He had prerpousely turned off their alarm to get to her?


  15. November 22, 2015 at 8:36 pm | Posted by Diane Gonzales

    I am a caregiver for a 85 year old women with fast progressing dementia. She came across a death certificate of a man that she was head over heals for. He died out of the blue in 2002. All of the sudden she is starting to close her bedroom door, and we have baby monitors in place so that we can hear her from the kitchen, just in case she falls or we know when she is waking up. But we heard a tapping noise followed by her saying ouch. She forgot to close the door all of the way and her son saw her spanking her bare bottom with a brush. From what I can hear through the baby monitor it sounds like she is masturbating. It's like she is rediscovering her pleasure center. She is in a better mood, and seems happier. However, she has been at this for 3 almost 4 days straight. She doesn't even finish her meal before going back in her room, with the door closed, so unlike her no closed door policy, and she continues to play with herself, moaning, and calling out the name of her deceased lover. Please tell me what I should do. I have researched this, but just like the internet says, this subject is rarely talked about. She has 3 older son's, and they don't want to talk about it either. Please help. I know I need to include her MD, but I would love some advice now. Any suggestions would be deeply appreciated. Thank you so much. Dazed and Confused, Diane


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