Sex and aging adults. It’s the butt of all too many jokes — dirty old men…rigid or sex-starved women…wrinkled bodies…impotence. But as we live longer and social mores evolve, aging adults are becoming more vocal about sexual needs and intimate relationships well past the age of 60. Indeed, sexuality is a core human quality, essential to a fulfilling relationship. While illness and infirmities may change the way older adults express their sexuality, the need for intimacy does not fade with age.
Touchy Topics: Dementia and Sexuality in Aging Adults
By Deborah Liss Fins, MSSW, LICSW, CMC, Aging Life Care Association™ Member
and Fellow of the Leadership Academy
When a loved one develops Alzheimer’s or another form of dementia, sexuality and the ability to express sexual desires can change radically. For a partner or spouse, as well as for adult children and caregivers, this can lead to much confusion, concern, embarrassment, and, sometimes, resentment or guilt.
It’s the Disease, Not the Individual, Causing Changes in Sexual Expression
What’s important to remember is this: Dementia is a symptom of various brain diseases. As the brain changes, so might behavior. Sexual expressiveness is one behavior that might change, but the individual is not acting intentionally. Understanding the dementia process will help all involved to respond in ways that are truly helpful to the patient and those close to him or her.
Dementia can Affect Sexuality and Relationships
Some individuals may lose interest in sexual relations. Others may lose sexual inhibitions and become overly interested or insistent about having sexual relations with a partner or others. For the patient’s partner, either situation can be deeply upsetting, prompting feelings of rejection or isolation on the one hand, or fear of sexual abuse and a need for new boundaries, on the other. Regardless, the partner needs support, and an opportunity to gain insight into his or her reactions as well as coping skills.
It is also possible, however, for sexuality to continue despite dementia. For some couples, this intimacy may be the only form of communication left in a relationship.
Shaming and Blaming Don’t Help
For adult children, coming to terms with a parent’s sexuality, especially when his or her inhibitions are lowered due to changes in the brain, can be confusing and deeply challenging. Knowing what to say or do when your parent forgets how to behave in public and begins to undress or masturbate, or uses vulgar language or becomes sexually aggressive, takes insight and practice — and a lot of patience.
Again, it is essential to remember that it is the disease causing the inappropriate behavior. Use this as a framework before responding, to maintain your equanimity and avoid overreacting. Shaming, ridiculing, arguing or yelling at your parent will not teach her to change her behavior; more likely, it will only make the two of you feel worse.
Try a Little Tenderness
A more effective approach is to be matter-of-fact and caring. You can gently remind your parent that the behavior is inappropriate in public as you guide him to a private space or simply distract him.
There may also be some very practical reasons that your parent’s sexual behavior has changed. For example, if she suddenly begins to undress, she may be tired and think it’s time for bed, or feel constricted in too-tight clothes, be too hot, or need to use the toilet.
A parent with dementia who becomes sexually aggressive toward others, such as fellow residents in a nursing home, may just be confused and mistake someone else for a spouse or sexual partner.
On the flip side, a sudden loss of sexual desire for a spouse may be due to illness, hormonal imbalance, medication side-effects, depression, or sensing the emotional withdrawal of the other partner.
Get the Support that You and Your Parent Need
Any sudden, dramatic change in sexual expression merits a medical evaluation. Sexuality and the need for physical connection are very basic human drives and a fundamental expression of the need for affection.
If, however, you find that dealing with your parent’s sexuality is simply too difficult, get help — both the emotional support you need to sort out your own feelings and establish appropriate boundaries, as well as the responsible care that your parent needs to feel safe, supported, and able to maintain healthy relationships.
Aging Life Care Professionals™ can help you understand your loved one’s behaviors and help you handle the challenges that may come with caring for someone with dementia. For an expert near you, visit aginglifecare.org for a searchable directory.
About the author: Deborah Liss Fins has over 35 years of experience in aging life care issues. She is the President of Deborah Fins Associates, PC in Worcester, MA. Debbie is a member of the Board of Directors of the Aging Life Care Association™ and co-chair of the Education Committee. Follow her on LinkedIn and Twitter @DeborahFinsALCM or email her at DLFins@finseldercare.com. Deborah Fins Associates has a presence on Facebook – we invite you to like our page.
This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.
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