Inappropriate sexual behavior in dementia is difficult to handle
Inappropriate sexual behavior is a disturbing thing that can happen when someone has Alzheimer’s or dementia. It can be one of the most challenging behaviors to handle because it often makes caregivers feel uncomfortable, embarrassed, or frightened.
We explain what causes this behavior, share 9 ways to help you cope, and give plenty of ideas and examples.
What causes sexually inappropriate behavior in dementia
It might seem strange that someone you once knew as proper or respectful might suddenly be showing sexually inappropriate behavior.
The most important thing to understand is that this behavior is caused by damage in their brain, it’s not something they’re doing on purpose. Dementia affects parts of the brain that control a person’s ability to control their own responses. That’s why it’s important to learn how to distract and redirect them to more appropriate activities.
A person with dementia could act in sexually inappropriate ways toward their spouse, their own children, professional caregivers, or strangers. They are likely to be confused about who a person is or might have forgotten that they already have a spouse. They may become angry or upset if they feel rejected.
Inappropriate sexual behavior could be caused by a need to feel intimacy again, needing comfort, or being bored. Sometimes, people with dementia may even take off their clothes or masturbate in public. This could be caused by disorientation – not knowing they’re not in a private place. Or, it could be because they’re uncomfortable or need to use the toilet.
9 ways to cope with Alzheimer’s and sexually inappropriate behavior
Each person will respond differently to these responses and interventions. That’s why we’ve included lots of suggestions and tips – experiment to see which ones work for your older adult.
1. Manage inappropriate behavior when it happens
- Stay calm and be patient.
- Gently but firmly tell the person that the behavior is inappropriate.
- Match your body language to your words – frown and shake your head. People with dementia are better at reading nonverbal cues.
- Maintain consistent, firm boundaries. Don’t accidentally encourage inappropriate behavior by sending mixed signals, like briefly allowing the behavior one time and then reacting negatively the next time. Be consistently firm every time, saying “No, stop. I don’t like that.” or “Stop, that’s not right.”
- Distract them and redirect to a positive activity. To distract, ask a question, turn on the TV, or offer a snack. To redirect, turn on some music they like, go for a walk, bring out their favorite hobby
- Move your older adult to another location. This takes them away from what’s triggering their behavior. Guide them to a quiet area in a public place or to their bedroom at home.
- If nothing else works, shock them a bit by raising your voice and firmly saying “No!” Grab their hands and put them back in their lap. Look them in the eye, frown, and shake your head to let them know this behavior will not be tolerated.
2. Explain sexual behavior to other people
- Let family, friends, and visitors know ahead of time that inappropriate behavior or sexual remarks might happen and that it’s caused by the damage to their brain from Alzheimer’s or dementia.
- Calmly ask other adults to excuse their behavior or advise them to step back a bit.
- Keep a little space between your older adult and other people. When you walk them into a room, leave enough space so they can’t easily touch someone, especially if they tend to grab.
3. Identify triggers and try to prevent the inappropriate behavior from starting
- Keep their hands occupied with a fidget activity or sensory activity.
- Provide alternatives to cuddling – a soft blanket, stuffed animal, or doll can satisfy the need to touch.
- Boredom can also cause sexual behavior. Keep your older adult happily occupied with different types of engaging activities.
- Keep a caregiving journal of the inappropriate behaviors to figure out the triggers. You might notice that mom lifts her skirt or dad touches himself when they need to use the bathroom.
4. Make it difficult for them to remove clothing
To prevent spontaneous undressing, get specially designed clothing that closes in the back so it’s difficult for them to take their clothes off.
5. Talk with a doctor, nurse, or other healthcare professional
Talk with their doctor, a nurse, or another healthcare professional. They may be able to figure out what’s causing the behavior and how to treat it.
6. Lean on trusted family or friends
Consider talking with a trusted family member or friend. That gives you an ally in your circle who will be aware of what’s happening and can offer emotional support.
7. Join a caregiver support group
You’re not alone in dealing with sensitive issues like this. Caregiver support groups are an excellent source of support. If you’re shy about speaking about sex in person, you might be more comfortable in an online support group.
Memory People on Facebook is a wonderful group and also has a women’s only subgroup where members feel more comfortable discussing sex.
8. Spouses can adapt relationships and find other ways to fulfill the need to be close
Sex between you and your spouse with dementia is a complex topic. It’s important to recognize that sexual desires and drives might change for both of you. In the early stages, encourage them to discuss their feelings and emphasize the value of your relationship with or without sex. A therapist could also help with these discussions.
Additional tips for spouses:
- Give extra reassurance and physical attention through activities like snuggling while watching TV, giving hugs or a massage, dancing together.
- Showing affection through touching or kissing could also give the comfort and security that comes from being with the person they trust.
- If it feels right for you, consider separate sleeping arrangements.
9. Prepare for sexual behavior in assisted living or memory care
Ask the assisted living community about their policy on sexual relationships and behaviors. It’s especially important to discuss policies related to sexual abuse and a resident’s ability to give meaningful consent.
Recommended for you:
— 6 Ways to Help Seniors with Alzheimer’s Keep Hands Busy
— 12 Engaging Activities for Seniors with Dementia: Reduce Agitation and Boost Mood
— The Positive Effect of Therapy Dolls for Dementia
By DailyCaring Editorial Team
Image: Laura Kay House