"My partner is in a care facility, but I'd still like to continue our sexual relationship."

Layered on top of ethical considerations is the not-so-small matter of privacy, when one or both members of a couple lives in a communal facility. But sexual communication is important to a relationship, and it's worth preserving if possible.

Assisted-living facilities struggle with this issue every day. Staff, often relatively young aides, have little training or experience in dealing with it and may actively discourage time alone for married couples.

For starters, your spouse needs a private room and not a semiprivate one; asking roommates to leave is too much. One option is to discuss the situation directly with management. Ask about its policy for private time for couples, the best times for conjugal visits, and how to ensure you won't be disturbed (a locked door? A sign?). Use words like "privacy" or "private time" if you're uncomfortable talking about sex.

For this and every sexual situation, Robbins recommends dementia caregivers look into joining a support group of those in similar straits. "These groups aren't just for empathy and emotional support -- they excel at being strategy sessions where others share practical advice about what worked for them."