Dementia and sexual relationships
A sexual relationship can be an important part of a person’s wellbeing. A person with dementia has the same needs as anyone else. Dementia changes how the brain works. These changes can affect feelings and behaviour, including close relationships.
Changing relationships
Having dementia does not mean a person cannot have a healthy sex life.
Many couples will continue their sexual relationship after a dementia diagnosis.
But as dementia progresses, a person may seem distant or not recognise their partner.
Sometimes they might forget they’ve had sex and become overly demanding.
Dementia, the brain and sexuality
Having dementia can affect how the brain works and sometimes people with dementia will behave in a way that’s out of character or socially inappropriate.
Dementia can affect a person’s ability to inhibit their thoughts and behaviour.
They might:
- say or do things in public that they would usually keep private
- show different levels of interest in sex
- be more or less able to perform sexually
- be less sensitive to others and perhaps aggressive
- use sexualised language that others have not heard them use or that seems out of character
- make unwanted sexual advances towards others or mistake them for their partner
- misinterpret the intentions of those supporting them with personal care tasks, such as washing and dressing
Some partners and families can adapt to these changes, but others will find it hard and upsetting.
They might experience feelings of loss, anger, embarrassment, anxiety, fear or frustration.
If someone with dementia is unable to express their feelings verbally, their behaviour, however inappropriate, may be a form of expression.
Responding to inappropriate behaviour
Sometimes understanding the changes in behaviour can help you accept and adjust to them.
A person with dementia can find it hard to express their needs and feelings. Their behaviour can be a sign these needs aren’t being met.
If someone with dementia is showing unsuitable sexual behaviour, consider whether they:
- might have an infection
- could be in pain
- are too hot or cold
- are feeling uncomfortable
- have enough privacy
- feel lonely
- are feeling bored
If someone with dementia is acting inappropriately, they might be uncomfortable or need more privacy. You can:
- sensitively distract them
- encourage them to go somewhere private
- use humour respectfully to ease the situation
- if the person is not your partner, tell them that you’re in a relationship
- change the conversation, such as a story they like telling
- gently remind them who you are if they have mistaken you for someone else
- firmly but politely tell them you feel uncomfortable
- walk away
- ask for help
Helping someone meet their needs in the right way
A person with dementia can feel lonely and afraid.
They often need help to make sense of the world around them.
Offering them help and support can help reduce the risk of unsuitable behaviour.
Things that might help include:
- encouraging friends and family to spend time with the person in activities that are suitable for their abilities and interests
- appropriate physical contact with them, such as holding or massaging their hand, hugging them or sitting close to them
- giving them something comforting to hold, such as a blanket or soft toy
Care homes
People with dementia who live in care homes may continue to have sexual relationships.
This might be with their partner or they might form new sexual relationships with other residents.
This can be hard for a family to accept, especially if the relationship is not with the person’s recognised partner.
The home manager must make sure families are fully involved in discussions about how to deal with the situation.
If you have a relative with dementia living in a care home and you have any concerns, speak to the manager.
All care homes should have a policy on sexual relationships which:
- safeguards the rights of all residents
- ensures privacy for all residents
- promotes and protects the emotional wellbeing of residents and their families
The manager and all staff at the home should be aware of the policy.
They should be trained on how to respond to issues around relationships, sexuality and sexual health.
Consent, capacity and protection
Simply having a diagnosis of dementia doesn’t mean that someone lacks mental capacity to give consent.
Capacity is always specific to a particular decision at a particular time.
Partners should learn to recognise how the person with dementia might try to communicate their consent to intimacy. This can include non-verbal messages.
Sometimes the person with dementia might find it hard to understand:
- the needs of their partner
- that their partner doesn’t consent to sex
It is important that their partner responds in a way that’s clear, but sensitive, so the person doesn’t feel rejected or unloved.
Think about other ways to show affection, such as holding hands or hugging.
Safe sex and sexual health
Anyone starting a new relationship, or people in a long-term relationship who haven’t done so, should talk about safe sex.
You can speak to your GP in confidence if you have any worries.
Help and support
You can find further information on dementia and support services available at the link below: