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Seniors, Sex & Dementia: Managing Inappropriate Behavior

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One of the most awkward and challenging of dementia symptoms are those that result in inappropriate sexual behavior. One family caregiver told the story of when her dad invited his brother, who had dementia, over for lunch.

“When I greeted him, we hugged,” the family caregiver said. “But, to my surprise, the hug lingered while he ran his hands down my back. I didn’t know how to react so I changed the subject. Then, as I was bringing lunch to the table, my uncle commented about my pretty legs. After the second incident, I realized this was not the action of my uncle, but the disease. I went back to the kitchen and took a few deep breaths. As they day went on, I was prepared to distract my uncle if anything happened again.”

It’s a known fact that certain medical conditions—like dementia and Alzheimer’s disease—can cause seniors to engage in inappropriate sexual behavior. This development can be disturbing if this is happening with your loved one.

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. Stressful, right?

Let’s look at three common situations and how to cope with them. You can also find additional tips and suggestions for managing inappropriate behavior on HelpForAlzheimersFamilies.com.

  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.)”

If your loved one who is fondling himself in public, 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.

The caregiver above found that 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.”

  1. 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 a senior to enjoy the physical touch of family members while ensuring hands don’t inadvertently wander where they shouldn’t go.

  1. 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. 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, manage the activity as it occurs. Take a shawl or throw with you to cover a loved one as the clothes come off. Stay calm and try not to shame your loved one. Understand that you cannot necessarily control this behavior.

Keep the Conversation Going

You may be reluctant to discuss this subject. That’s why it will be helpful to find others who may be going through the same issues. Contact your local Alzheimer’s Association [https://www.alz.org] to find a support group in your area. Or, join an online community like the Remember For Alzheimer’s Facebook community for inspiration and support.

Last revised: July 1, 2015

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Thoughts and stories from others
  1. October 29, 2019 at 5:50 pm | Posted by Candyce Ayala

    I have a sweet 81 y. o. Female neighbor who did the whole tongue in mouth suddenly. I was upset. I confronted her; she had been drinking a fair amount of wine and said she had no recall and was herself appalled. A week later she told me my husband had made a tongue in mouth comment to her. My guy is known for his firm boundaries. He was very quiet when I shared this ...then he suggested onset dementia and 3 recent falls she had. Still waiting to learn if ..yuk..more of the saga plays out. Hubby keeping distance. Sigh.

    Reply

  2. October 18, 2019 at 5:25 pm | Posted by Lori A Chester

    My elderly father has begun to tell me the crudest jokes when we are alone. He uses awful language and crude words for body parts. He's never done this before. He's also become very racist in front of me. The other day he came into the kitchen without his shirt on, which was VERY odd. I felt very uncomfortable. Is this an early sign of dementia? He's 79 and not in good shape, and eats a horrible diet. He's mobile right now but getting weaker quickly

    Reply

    • December 4, 2019 at 6:42 pm | Posted by Ken E

      It sounds like that inappropriate behavior could very well be symptomatic of dementia or alzheimer's. I am in the early stages myself and, although I have not given in to them, I find that more crude language comes to mind than ever before. Also, despite being 79 years old, I find myself having a great deal of sexual thoughts and feelings. Fortunately, these things have only been in my mind. Both of these things are not at all characteristic of my personality. I attribute this to the changes taking place in my brain. Good luck.

      Reply

  3. July 29, 2019 at 2:45 pm | Posted by Joleen Gutter

    @Annie, considering the number of unhappy marriages around me, I would say men being duped by looks and charm has contributed to the singleness of some very lovely single ladies in our community. Why should they feel badly? It is the contentious wife that should feel ashamed.http://www.apsense.com/article/unanswered-questions-home-care-nursing-services.html

    Reply

  4. June 26, 2019 at 1:07 am | Posted by Karen B

    I work with males and females who are at various stages of dementia. Sometimes the verbal boundaries given today are gone tomorrow, sometimes not. But that's where I start. "I'll give you a hug, we all need hugs, but just a hug." Another man makes rather distinct suggestive comments. "Why don't you come into my bed?" This man's dementia is very clear, but he does not seem to realize he is in a wheel chair, and that a stroke has stolen most of his right side. A rather proper woman danced suggestively around her living room, surprising everyone. "I have nice breasts." I just keep remembering that it is the condition, not the person.

    Reply

  5. June 12, 2019 at 7:03 pm | Posted by Bobbie Sena

    Really terrifying info! None of my ancestors ever had any kind of dementia even though they all lived into their late 9o's or early 100's.I am now 85, strong, healthy, pain free, and med free. i see so many elderly friends younger than me deteriorating mentally, and it is sad. However, they all maintain decency and dignity. I feel that possibly the overuse of tranquilizers and narcotic pain meds is causing what seems to be a dementia epidemic. I have thrown away a lot of meds prescriptions without ever filling them. I pray God will protect my beautiful brain.

    Reply

  6. May 8, 2019 at 1:04 pm | Posted by Dayna

    My grandfather hits in me, flirts and tells me he wants to have sex with me. I love him so very much and want to spend time with him but dont know how to handle this. Any advise?

    Reply

    • July 14, 2019 at 4:35 pm | Posted by toni

      That is very difficult to deal with. Be careful and set very clear boundaries with yourself and him. Make sure you feel safe and do not be afraid to discuss this with a trusted friend or medical team. Tell him this is not appropriate and you do not want to have the discussion.

      Reply

  7. April 23, 2019 at 1:41 pm | Posted by Nichole Mcdonald

    So, as I read this. I am flustered She is on a Memory Care Unit! This is absolutely inappropriate! I’m sickened by this. Is there a patient advocate? It’s memory care not a brothel

    Reply

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