Sexuality | Just the Facts

All human beings need to be touched, caressed, and held. For Alzheimer's patients and caregivers, this need is especially important. Alzheimer's disease affects people in varying ways. One person may have an increased interest in sex while another may have no interest. Changes in the sexuality of people with Alzheimer's disease include the following:

Bold Behavior

The person may forget his or her marital status and begin to flirt or make inappropriate advances towards members of the opposite sex.

Exposure

The person may forget how to dress or take her clothes off at inappropriate times and in unusual settings. For example, a woman or man may remove a blouse or shirt simply because it's too tight and he/she feels uncomfortable. The person doesn't realize or understand that clothes shouldn't be removed in public places.

Fondling

The person may forget social rules or etiquette and fondle himself in public. Although it looks like the person is trying to harass or embarrass others, he really doesn't understand that his behavior is inappropriate.

Paranoia

The person may become unreasonable jealous and suspicious. For example, the person may think that his wife has a boyfriend, and accuse her of going to see him.

Misinterpretations

The person may make sexual advances to a stranger who resembles a former spouse, lover or companion. In addition, the patient may forget that he or she is married and approach a person in a sexual manner.

Physical Illness

Physical illness may cause the person to lose interest in sex or make sexual intercourse difficult or painful. Reactions to medications may also reduce sexual desire.

Depression

Depression can reduce interest in sex, both by the patient and their spouse or loved one. Some caregivers report that they experience changes in sexual feelings toward their loved one after providing daily caretaking actions. By understanding these factors, and recognizing that they may affect you and the person with Alzheimer's, you will be able to respond better to the sexual needs of the person with Alzheimer's disease.

Action Steps

Look for a reason behind the behavior. Keep in mind that if the person exposes himself; he may simply need to go to the bathroom. If the person begins to take off his clothes, he may want to go to bed.

React to the person with patience and gentleness. If the person is engaging in unusual sexual behavior, carefully remind him or her that the behavior is inappropriate. Then, lead the person to a private place or try to distract with another activity. Try not to get angry with the person or laugh and giggle at the behavior. In most cases, anger and ridicule may cause negative reactions.

Respond carefully to threats and accusations. If the person levels accusations or becomes extremely suspicious, don't waste time arguing. Instead, try to distract the person with another activity or reassure him with a hug or touch.

Adjust the person's clothing. Consider putting the person's trousers or dress on backward. Or provide the person with pull-on pants with no zipper.

Increase the level of appropriate physical contact. Give the person plenty of physical contact in the form of stroking, hugging, and rubbing. In many cases, the person is anxious and needs reassurance through touch and gentle loving communication.

Adjust to changes in sexual desire. As the disease progresses, a spouse may choose to sleep apart from the patient - especially if the person becomes overly demanding, jealous or irrational.

Seek outside help to deal with sexual issues. If you consult an outside expert about sexual problems, make sure the professional understands the nature of the disease and will discuss sexual issues openly.

Resources

One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 200 Chapters and 1,600 support groups nationwide, where family members of patients with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.

The primary resource for this fact sheet was Peter V. Rabins, M.D., a geriatric psychiatrist and director of the Price Teaching Service and associate professor of psychiatry at the John Hopkins University School of Medicine, Baltimore, M.D.

Special tanks goes to Alzheimer's Association - Eastern Massachusetts Chapter and the South Central Michigan Chapter.

David L. Carroll. WHEN OUR LOVED ONE HAS ALZHEIMER'S. New York: Harper and Row Publishers, 1989.

Donna Cohen, Ph.D. and Carl Eisdorfer, Ph.D., M.D. THE 36-HOUR DAY. Baltimore: The John Hopkins University Press, 1991.

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