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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. August 7, 2021 at 1:22 pm | Posted by Mr Hayes

    My wife has dementia and continues to ask me for sex and I don't feel like it is a good idea because she has dementia and doesn't really know what she is asking, does she?

    Reply

  2. August 6, 2021 at 1:45 am | Posted by DistressedJess

    Preface: I am 41 years old. Two years ago my step-dad drank too much at dinner and then tried to make out with me while my mom was rinsing something in the kitchen, I was just starting to clear the table. I walked quickly away with the plates to the kitchen. In shock and not sure what to do, I put the plates next to my mom and sat down on a stool next to her, facing her perpendicularly. The next thing you know, I look to my right and he is trying to rub his flaccid ugh. He has always been a drinker, but in 18 years nothing like that had happened. He comes from a family history of trauma and alcoholism, his dad was a mean drunk. I just came to stay with them for the first time in two years, the last time I came to visit I stayed somewhere else. My mom said she pours his drinks for him now so he doesn't get like that. But now tonight she told me that he had an MRI that showed a stroke and brain shrinkage. Yet she said his doctor said he can still drink in moderation and take Dimenhydrinate (an anticholinergic) to sleep at night. They have so much gin here, that he snuck so much when my mom and I went to get pizza (into the cup she had previously poured him) that he was shuffling and passed out by 8:30 pm. Now he's on the couch between me and the bathroom almost 2 am and when I came out of the bathroom he clearly had his hands under the blankets and asked in a creepy voice "what's going on." I don't think there should be alcohol in the house, or it should be locked up. What do you think?

    Reply

  3. July 17, 2021 at 11:55 pm | Posted by Gary

    I have heard of a few cases where family members have made arrangements which make everyone happy, but they are not legal in most places in the US. However, they are legal in many other countries. The movie "The Sessions", starring Helen Hunt, is the true story of a somewhat similar situation.

    Reply

  4. June 2, 2021 at 11:02 am | Posted by Kathleen

    I am the caregiver to an 85 year old gentlemen in early dementia. While infrequent, he has both touched me inappropriately and been verbally inappropriate. After a fresh request that I won’t repeat I asked him what was going on. He replied that he didn’t know and I explained that we didn’t have that kind of relationship and that it was disrespectful. He said that he was just ‘horny’. As his caregiver I’d like to give him options if in fact that’s a healthy alternative. Should I suggest he take care of it on his own?

    Reply

  5. May 26, 2021 at 8:20 am | Posted by Jean Grunhannes

    ISB can be medicated with anti androgen medications

    Reply

    • June 12, 2021 at 10:10 pm | Posted by tricia1963

      Would you know how can I go about finding a specialist who can give these shots for my father.

      Reply

  6. May 26, 2021 at 8:16 am | Posted by Jean Grunhannes

    I had a similar event with my father.Over time the situation worsened.My sister and I came to the conclusion to have him medicated.My sister who is a nurse asked her supervisor for an appropriate solution.After a long discussion ,my father agreed to have himself clamped ,an bloodless in office procedure to suppress his libido.

    Reply

  7. March 26, 2021 at 2:36 pm | Posted by Jamie

    I just have to say reading all of the stories that I’m grateful there is a place such as this to vent or seek out advice… All of the above! We dealt with all types of inappropriate behavior with my mom who suffered for Alzheimer’s disease and has since passed and now her husband, my dad lives with us and seems obsessed with sex. Constantly flirting and joking, which that wouldn’t be bad except most of the young women, nurses, even my college daughters friends all view it as he’s being a funny old man, “crazy Papa” and silly but then he mistakes their kindness or laughter for acceptance. He then starts calling them and texting them, often inappropriate conversations including demanding to know who they’re dating because he wants to be in an “exclusive relationship” with them...?! This is caused numerous issues that, so far, we’ve been able to somewhat fix or explain. I’ve had too many to count conversations with him about being careful how he acts, hugs or talk to others. Just simply trying to kindly remind him for instance these are his granddaughters friends and they view him as a grandfather or papa. Sometimes he seems to get it and other times he looks at me like I’m crazy. 🤦🏽‍♀️ With all that said, and many years of experience at this point along with numerous psychiatrists, social workers and neurologists I’ve learned that this behavior is very common and can have a multitude of underlying reasoning or meanings. As appalling as this behavior can be, we have to try to remember the real person that we do love and know is inside of there and there is obviously some confusion. (Of course if they behaved this way their whole lives, that could be another issue and definitely separate from dealing with an elderly dementia patient) I know for certain that my mom was a lady and would have never, ever have engaged and half of the court activities include her behavior that she did in her final years if it had not been for I’ll timers. And I also know my father has always been a gentleman, always careful to watch his language and topics of conversation in front of Women and children all of which makes it even harder when these occurrences happen. And my daughters and I along with the rest of the family I’m blessed to still have this time with him here on earth. Time to still love him and talk to him, redirect has attention to some thing interesting or fun. As my mom was passing away late one night, after 4 hours of hospice saying “the time is very near”, she took her last breath as I held her hand, and I realized how quickly it’s just over. Even though we knew that time was coming, there was something so definite and final about her death that hit me harder than I’d anticipated. Had there been any words left unspoken, prayers left to say, hugs or even telling her how much I love her… she was gone. My point is it’s not easy being a caregiver and it comes with an awful lot of stress and often frustration but it can also be a blessing and possibly some of the most beautiful moments you spend with your loved one before they go home to heaven. My mom held me as she welcomed me into this world and I got to hold her hand as she left this world. I got to walk my mom home. ♥️

    Reply

  8. March 26, 2021 at 12:53 pm | Posted by Jamie

    My father is 74 years old and he has had several strokes that have affected his cognitive abilities, slight dementia and poorly managed diabetes which affects his mental abilities. My point is, I completely relate with you regarding what your father/grandfather has said! It is absolutely disgusting and you’re not wrong for having those feelings, especially when it comes to protecting your daughter. At the same time, as it has been explained to me by numerous doctors, psychiatrist and neurologist, more than likely he either didn’t recognize that was his granddaughter or didn’t realize what he was saying. Also, the time or “era” he was in, especially given the fact he’d just lost his wife. I would guess that, in his completely right mind that he would be absolutely devastated and ashamed of his behavior as I know my father has been. With my dad, I care for him 24 hours a day seven days a week and let me tell you, sometimes the conversations take an awful turn for the worse. Almost like he thinks he’s talking to an old buddy at the bar and I have to clarify and remind him “dad! I am your daughter and that your granddaughter so please watch how you talk.“ And that does seem to help... sometimes it causes more confusion yet often times he’s backed away with his head down, sometimes confused or angry but we are able to move on and I think the most important thing is that I know without a doubt he would never do or say anything to harm me, his grandchildren or any other woman. My mother passed away from Alzheimer’s about seven years ago and, prior to her passing she had made a “boyfriend“ in the nursing home and they had become sexually active! However, as it was explained to me, she was confident that was her husband and the nurses explain to me they couldn’t necessarily stop them because they’re adults and both in agreement. She did say however, usually when it actually comes down to “it“ happening, they usually forget! No of course that’s talking about you older and consenting adults, though they may not be in their right mind. My point was just to say this type of behavior is not uncommon and it can be unsettling but there are definitely ways you can deal with it and still be there for your loved one. Ps: I often really miss my old dad! He wouldn’t behave this way and I miss him while he’s here. I don’t look forward to when he’s not.

    Reply

  9. January 24, 2021 at 2:24 am | Posted by Donna petersen

    My dad asked my daughter if he could go down on her. We as a family are devastated and don’t know how to approach this. My mother, his wife, has just died 1 week ago. We have not even laid her to rest as yet. We are sickened by this and feel like we want to turn our back on him. Please advise. Mom was 98 yrs old and dad is 90 and in assisted living home.

    Reply

    • February 13, 2021 at 6:53 am | Posted by susan

      It sounds like your dad has dementia and probably goes in and out of reality. Before my dad died he was having some dementia. An example of the effect on him is we were watching TV and he seemed to know the time and place. A commercial came on for an old movie from the 1950s which starred one of his favorite actresses. He became very confused and asked me if it was a new movie coming out. He almost said I thought she was dead but he stopped himself. I could tell that he was trying to hide his confusion. Shortly after that, he asked me if I was my mother's daughter. Your dad may have time and place issues. There may be times that he doesn't even realize that he and his granddaughter are related. There may be times that he thinks it is 40 or 50 years ago. My guess is your dad never really talked that way. Dementia can cause inappropriate sexual behavior. My guess is that your dad may be experiencing that. If so, it is most likely the disease talking and not him.

      Reply

  10. December 31, 2020 at 12:40 pm | Posted by Lynwood Hinderberger

    I agree with you

    Reply

  11. October 28, 2020 at 3:56 pm | Posted by Victoria Thornbury

    I'm having an issue with my father-in-law. We spend weekends at my husbands parents house to help out around the house. This past weekend he came into my bathroom, while I was naked and getting into the shower. He started hugging me and saying very inappropriate things. I pushed him out of the bathroom and told him that was not okay. I had made a decision to not tell my Husband. His father is his hero. I lasted 2 days without telling him. I was just so overwhelmed with what had happened. My husband is furious and has not calmed down. He wants to confront his father. I don't know if that is a good idea. I don't think his father will really remember the incident well and if he does he is going to be so ashamed. My question is; Should he be confronted or should we just be aware of this and take appropriate steps to avoid further inappropriate moments.

    Reply

  12. October 12, 2020 at 10:03 pm | Posted by Jilly_K

    What can be done about an elderly parent who is acting like a love-sick teenager toward a much younger neighbor (who has been nothing but friendly and helpful), yet the parent is still married to a spouse with alzheimers, and the neighbor is also married to their own spouse?

    Reply

  13. October 12, 2020 at 5:31 am | Posted by Mary

    I have just been told that my dad said something to one of his careers that was very inappropriate I feel sick and disgusting feel like he makes me sick he has never done anything like this before he is almost 90

    Reply

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    Thanks, I've recently been looking for info approximately this topic for a long time and yours is the best I have came upon till now. However, what about the bottom line? Are you certain concerning the source?

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