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Seniors, Sex & Dementia: Managing Inappropriate Behavior

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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!”

Last revised: July 1, 2015

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Thoughts and stories from others
  1. February 28, 2019 at 2:23 pm | Posted by Gary Hayes

    My wife continues to have a male guest in the bed with her when I come to visit. I brought it to the staffs attention but they just respond that she has rights that cannot be infringed upon. I indicated that in spite of my wanting her to be content and happy, she is still my wife and I want her protected. She sees nothing wrong with having a male friend and I personally feel uncomfortable with that type of friendship in a memory assisted environment. The staff has brought it to my attention that I appear uncomfortable and ask if there is something wrong? I do feel uncomfortable and do my best not to show it so I won't upset anyone. Are my feelings not as important as hers?


  2. February 1, 2019 at 8:58 pm | Posted by Garrett

    Elderly sexual needs are real! There are a small number of men who are interested in older women and yes, even elderly ladies. Social norm says that that's gross but humans have unusual interests or preferences, even in sexual ways.The activities between an elderly lady and her young man may includeGerontophilia should not be shunned as gross or weird but accepted and even encouraged when a mutual match is found. The partnership between a young virile man and an elderly woman can range from platonic to sensual fondling, loving, and yes, sexually erotic match for each other. Activities can include bathing, napping, talking, watching movies together, cooking, and a full range of intimacy.It is important that both participants be willing. It would be best to facilitate such relationships whereby caretakers and their loved ones could have special private rooms.There should be an application for this. I, for one, would sign up and search for the elderly women I adore!Ladies, I want to hear from you! Comment below.


  3. February 1, 2019 at 7:05 pm | Posted by Jane Smith

    I work in a nursing home a younger man (58 ish) tried to restrain me and pull my pants down. I work as a nurse. This man has a "fried brain" (alcohol / drugs). The nursing home is making excuses for his behavior. Even with a touch of dementia, there is NO excuse for forced sexual advances


  4. December 8, 2018 at 5:12 pm | Posted by Patricia

    I’m upset because my husband of 82 has dementia .Hes in a care home and formed a relation with a woman also with dementia. I feel terrible when I see them together. What do I do?


  5. October 22, 2018 at 11:51 pm | Posted by Izzy

    We recently moved our in-laws cross country into our home. They had gotten into rough financial shape, with a reverse mortgage, multiple credit cards he’d taken out, etc. He has Alzheimer’s but because of her denial, we had no idea how far advanced it had gotten. He has made inappropriate advances toward me twice. My husband told his mother but she still hides out in their suite often. I simply don’t know how to handle it so if he comes into a room where I am alone, I immediately leave. At times, I feel as though I’m restricted in my own home. How do I handle this in a loving way?


    • April 18, 2019 at 2:54 pm | Posted by Jean

      Get them Out of your home , place them in a nursing home or tell other family members you WILL Not take care of them.


  6. August 24, 2018 at 5:34 pm | Posted by Sandra Hanley

    I am a caregiver for a 92 year old man. He was never diagnosed with Alzheimer's or dementia. He has become more forgetful this past year. His conversation when I try to get him out of bed goes immediately to his genitals, asking me to get in bed, wants me to dry his genitals and get a bit belligerent when I don't comply. I don't know what to do or say to him,I could use some suggesstions! Thank you!


    • September 5, 2018 at 11:31 pm | Posted by Rodney W

      I also have an issue developing with my father who is full time in a care institution following a stroke and starting to display inappropriate sexual behaviour with other residents. I wonder whether it isn't also an attempt to be recognized as a whole person. I remember visiting (what used to be called) the dementia ward of the hospital as a young male adult. A couple of the elderly women there would always be inviting me to jump into bed with them. I just said, "Sorry love, I don't think I could keep up with you." And they'd laugh and that was enough. So maybe that was just acknowledging them as a sexual person while still keeping appropriate boundaries. (I know when I've worked with divorced people, having been sexually active, it is also a struggle for them to no longer have that in their lives.) Not sure if this helps but most comments don't seem to take into account what need might be trying to be met by the person.


  7. August 14, 2018 at 3:07 pm | Posted by Brenda

    I think you should tell the son. This behavior seems to happen a lot with men with dementia. My husband does this which infuriates me—then he denies doing it. I would definitely tell the family. A nurse in the hospital told me my husband was masturbating in front of other people. I was mortified but was glad the nurse told me.


  8. July 11, 2018 at 6:41 pm | Posted by Lou Hanson

    Please call your home office and document the situation. Ask to be assigned another client. You should never have to work in a situation like this.


  9. July 11, 2018 at 6:39 pm | Posted by Lou Hanson

    Your caregiver may have had a history of childhood abuse or violence and may not be able to handle this behavior. Better to have another care giver then to put her through a painful work environment.


  10. July 6, 2018 at 9:10 pm | Posted by Kay

    My fsther is 94 and has Alzheimer's/dementia. He has 2 caregivers, one for night and one for day. Recently the caregiver who is there at night said she didn't want to take care of my dad anymore since he has been masterbaitng in front of her. I can understand that this is uncomfortable for her, but I feel she should know how to handle this situation since she has been a caregiver for many years and this is not that unusual for a man in my father's condition. I have never seem him touch himself, but I have seen him take off his clothes, or forget to pull up his pants after using the bathroom. I simple remind him to pull up his pants. Sorry, but if you can't handle situations like this, maybe you shouldn't be a caregiver for a man with Alzheimer's.


    • March 10, 2019 at 10:09 am | Posted by Rodna Achille

      Well as a caregiver myself. We have a option to choose who we want to work with. If there’s something that’s uncomfortable that the client is doing Alzheimer’s or not we have a RIGHT to decline services. There’s some men with Alzheimer’s doesn’t touch them self. Don’t be quick to judge.


  11. January 12, 2018 at 12:50 am | Posted by Halie

    I am a new caregiver for a 90 year old man with late stage alzhiemers. I have been working with him on my second week now. He has already had 4 incidences with me. I am extremely uncomfortable with the situation. The only way i can handle it is to threaten to tell his son about it and tell him its inappropriate, disrespectful and that im his caregiver. He states that he wants to "put his tongue in me", that i turn him on, tells me to lay on the floor, pull my pants down and has even went as far as to put his hands on my hips. I have stopped and prevented this behavior. It is extremely disturbing and stressful to me. I am 20 and a fresh worker. How do I go about notifying his family about this issue? I dont want them to know their father is being nasty with me and ruin his reputation. I have the patience but its causing stress in my own relationship. I dont want to quit my job because of this but i feel so uncomfortable that i cant pull forward with my routine with him.


    • January 18, 2018 at 12:20 am | Posted by James Lee

      Can't you tell your supervisor? Or can you go to counseling for support and for solutions that the counselor can offer. I would suggest a counselor with clinical knowledge, clinical degree and experience (LCSW or a Clinical Psychologist). You definitely need someone for support and someone to talk to about all of this. A caregiver needs protection of his or her boundaries and deserves that protection. Your workplace really needs to address this issue. If they have an Human Resource Department, start there. Don't put it off.


  12. December 16, 2017 at 8:49 am | Posted by Maria maysonet

    Hi , I am my mothers care giver and I always hug and kiss her ., i notice one day I stayed the nite with her in the nursing home because she had been screaming and calling my name , that she would pull on her pamper and I would tell her mom don't take it off cause it's dry but to my surprise she took my hand and put it on her top of her vagina and I was in awe ! She stared at me like " well aren't u going to do anything" so I quickly and gently told "no mom that vagina is yours and u take care of it ok , I have my own ok " and gently took my hand away and pulled the pamper over and she was content . But never the less I was very surprised., as I do know my mother was very active sexually even iat her age of 75 .


  13. December 1, 2017 at 11:24 am | Posted by Reg Coccaro

    Are there medications to help curtail this kind of behavior


  14. November 23, 2017 at 11:04 pm | Posted by Debra

    Having some of these same issues with my 82 year old father. He is making passes at both myself and my sister. My mother who is 80 years old is aware of the situation, and is encouraging it. She has cancer, and I think her chemo is affecting her ability to think clearly. It is very heartbreaking. Yes I feel like I don't want to be around them anymore, but when they were younger they were great parents. I never thought of it as a symptom of dementia - but it could be.


  15. November 18, 2017 at 5:50 pm | Posted by Carol

    My 89 year old father lives with me and my husband. My 36 year old daughter and my 3 grandchildren also live with us. My daughter has taken over the role as caregiver to my dad to help out.Today my dad asked his own granddaughter if she would mind giving him oral sex! She told him no and it’s not appropriate and she is his granddaughter. She has been taking care of him for a couple of months now and he never has said anything like this to her. I know it’s his dementia but it is so disturbing. What if he keeps this up with her? She still willing to care for him.


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