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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. January 6, 2022 at 1:45 am | Posted by Shelia

    My husband is 62, bipolar & has been on meds for the past 10 yrs for it. They still have another brain scan to do but they think he has Lewy body dementia & Parkinsonism now. We have been married for 42 yrs. Every time he closes his eyes he immediately starts dreaming of having sex with other women. He sleeps most of the time. Moving his head kissing the air, reaching his arm out and moving his hand. Saying pretty someone’s name. Touching hisself. Some master-baiting. It’s very disturbing to me. He has never done it in public. He is now seeing people, parties in our house. He sees things that are not there. There are times he doesn’t know me. What I am really upset about right now is that he hit our dog a couple of days ago. She is our baby, a lab mix rescue. She has become a nervous dog. My dog and I both have to take Zanax when needed.

    Reply

    • January 11, 2022 at 8:32 pm | Posted by Tammi

      I am going through similar situation. He won’t listen to me. He says I’m not his boss. Refuses his medications. He sleeps a lot, sits around naked, delusions about talking to people and having sec with them.

      Reply

  2. December 28, 2021 at 1:02 am | Posted by Sharon Douglas

    My husband was diagnosed with early stage Alzheimer’s and early stage Huntington's disease. He is aware of what is going on some of the time but he refuses to bathe or do any of the things the doctors tell him. He could hardly get around because all he does is sit in front of the TV all day. He refuses to go for a walk or to a senior center and he refuses to bathe. I was beside myself as we cannot go anywhere when he is dirty and stinks. I didn’t know what to do, I could not physically overpower him and make him do things and when I ask him he tells me I am not his boss. There has been little if any progress in finding a reliable treatment. His Primary care provider introduced me to Kycuyu Health Clinic and their amazing Herbal treatments. The treatment is a miracle. the disease is totally under control. No case of delusion, disorientation, forgetfulness, making things up, hallucination, Muscle weakness, jumbled speech, loss of appetite or confusion in the evening hours.

    Reply

  3. December 10, 2021 at 11:34 am | Posted by Lupe Aguilar

    I been taking care of my elderly neighbor who is 91 years old since 2017 August, he had few seizures from 2015 to this year and since halfway from October 2020 he had to be put in a hospice bed here at his house. His son does come to see him on Thursday to get his groceries and Sunday to give him his sponge bath but I have notice since 2019 that he doesn’t put that much attention to him like he use to! Before October 2020 happened his son use to take him out for a stroll in his wheelchair and the last time I took him for a walk and he uses a walker was back in the beginning of 2019 but he struggled to get up to walk so I stop taking him and his son was able to take his dad out using the wheelchair but a lot of things change when he had one of his son move in here with his grandpa and he already had his oldest son leaving here. My elderly neighbor barely spend time with his son because when he got here he was dealing with his younger son who was so lazy and not respectful to the house or his grandpa. October 13, 2020 my elderly neighbor has a fall that hurt his back and needed to be in a hospice bed, they had 3 different nurses come to check on him and give him a sponge bath but I notice that this February 2021 his son did took him out of bed to take him outside using the wheelchair the VA provided for him since 2018 and because he didn’t had any body movement only when I had to clean him or he got a sponge bath. He got dizzy, pass out and vomit outside while being in the wheelchair and his son told me that he will wait a week again to take him out. This was by the end of February 2021 and he try again, I told him that he needed to be taking him more out of bed so his body gets use of it and doesn’t pass out but one day I was here and his son took away the walker and wheelchair and I ask my elderly neighbor and he told me that he didn’t know or his son didn’t ask him about it. He also remove his home phone and when I ask him why he did that? He say because he doesn’t know how to use it and I told him that hr does and he gets very happy when he gets a phone call from his other son that leaves in Arizona and his sister and long time friend call him. My oldest daughter also comes to help him to give him his lunch and my son who is 18 years old also comes later in the evening to stay with him for more then one hour. His son and grandkids barely give him any attention and his son took almost 2 years to move out his younger son out of this house, he was causing so much issues here, like leaving a mess in the kitchen with dirty dishes, dirty clothes all around the house and will finish all the food that i had yo prepared for his grandpa and he will walk around sometimes naked or will just cover his front private. Few times I notice him peeing outside the back deck when I was in the kitchen making breakfast for his grandpa. All this issues I told jomto his dad and he told me before he move that any issues and 3 strikes and his younger son will be move out. He move here by the end on 2018 and right after the first week he started causing issues but he got move out October 2021. I have notice few times all this 4 1/2 years that I been taking care of my elderly neighbor that he will Masturbates and I notice it first because he will remove his disposable underwear and he will have his hands down there, but this year and this month I have notice when I get here in the morning time that he has his cover off and underwear and his hands on his private area and once he hear me walk to the house he will cover himself but starts to masturbate and it gets to the point that I leave the room and go to the kitchen because he doesn’t stop. I let his son know about it few days ago and I told him that he needs to have him do a follow up but he says that this is normal at his age but it gets very embarrassing and uncomfortable for me when he does that! Don’t know what else to do when his son doesn’t really wants to take care of his dad, today this morning he did it again but this time he only did it before I got here and he had remove his underwear and he will urine all over himself. Many times when he does this he leaves his private area out and will urine his shirt and bed covers. I do have to put bed pads under him and his bed covers. Please any advice or help on this!

    Reply

  4. November 14, 2021 at 3:58 pm | Posted by Princess

    My husband is always complaining of penile election but it is not erect. He is 77 years old with Alzheimer's.

    Reply

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