Dealing with dementia and sexually inappropriate behaviour

What is sexually inappropriate behaviour in someone with dementia?

While you may feel more ready to respond to symptoms of dementia such as loss of memory or hallucinations, you may not know what to do, when faced with sexual advances, a change in sexual interests or behaviour.

A person with dementia can act in a sexual way toward their partner, children, professional care staff or others. Family and others can feel embarrassed, uncomfortable, and even scared when faced with inappropriate sexual behaviour.

Sexually inappropriate behaviour from someone with dementia includes:

- Sexual acts. This includes touching or grabbing themselves, exposing themselves or masturbating publicly. It also includes grabbing others.

- Lewd, sexual comments.

A person with dementia can experience:

• Increased or reduced sexual appetite or no appetite for sex.

• Greater, diminished or no ability to perform sexually.

• A change in sexual responses, e.g. detached, less sensitive to partner’s needs.

• Change in level of inhibitions e.g. doing or saying things they would not normally do.

• Being sexually aggressive.

What causes sexually inappropriate behaviour in people with dementia?

As a person’s dementia develops, they might experience changes in their behaviour. They may not be able to control their behaviour, what they say or be able to communicate how they feel effectively. The individual may be unaware that they are doing something inappropriate or that their behaviour has changed.

A change in behaviour is caused by damage in the brain. Dementia affects parts of the brain that control a person’s ability to control their own responses. The brain controls all behaviour and emotions, including sexual feelings and inhibitions. Someone with dementia may have increased or reduced sexual feelings. They may take off their clothes or masturbate in public. This could be caused by not knowing they’re not in a private place. They may also misinterpret actions e.g. a carer giving personal care could be confused with sexual intimacy, feel lonely or be bored.

How to deal with dementia and inappropriate sexual behaviour.

It is important that people living with dementia receive care, but it is also important that any sexual behaviour in someone with dementia is tackled appropriately.

Here are a few ways to deal with inappropriate sexual behaviour:

1. Tell the person such behaviour is inappropriate and not wanted. Calmly and consistently call out inappropriate sexual behaviour. Say “No, stop. That’s not right.” Some people with dementia may understand nonverbal cues better than verbal communication. When you say “No”, look serious and shake your head to let them know their behaviour is not acceptable.

2. If they have confused you or someone else with their partner (e.g. confused a family member with a deceased wife), remind the person who you or the other person is.

3. If they are publicly displaying sexually inappropriate behaviour, e.g. touching people, or exposing themselves, take them somewhere quieter, less crowded to remove them from what may be triggering their behaviour.

4. When you are with them, make sure there is enough space between them and others so that they cannot touch them inappropriately.

5. Distract and redirect them. To distract, take the individual to another area, ask a question, show them flowers in the garden or offer them something to eat. To redirect them, turn on music they like, go for a walk, or do another activity they like.

6. If giving personal care, tell them what you are doing before you do it. e.g. ‘I am going to help you remove your clothes to have a shower’.

7. Boredom can cause sexual behaviour. Keep the person busy with varied activities.

8. To prevent undressing, you can get clothing that makes it hard for the wearer to take off their clothes. e.g. buttons fasten at the back.

9. Record all inappropriate behaviour to try to identify triggers.

10. If the person is being sexually abusive/aggressive and you feel you are in danger, remove yourself from harm and call 999.

What support can I get if a loved one with dementia displays sexually inappropriate behaviour?

• Talk to a health or social care professional.

- A doctor, nurse or care manager may be able to unearth the trigger behind the behaviour.

• If you decide your loved one should move into a care home:

- Ask about the care home’s policy on sexual relationships, intimacy, and inappropriate sexual behaviour.

• Talk to family or friends.

- Consider talking with a family member or friend. Let family, friends know that inappropriate behaviour might happen and that it’s caused by the damage to their brain from dementia.

• Helplines

- Find a support group of people who are going through similar experiences to you.

- You can also seek help and advice by contacting Admiral Nurse Dementia Helpline on

0800 888 6678 or Alzheimer’s Society on 0333 150 3456.

*Source: www.homecare.co.za