Caregivers and Sex

How to Stop Caregiving From Spoiling Your Sex Life
What your Eyes Say
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Taking care of an aging parent changes everything -- from the new financial stress to the scheduling of endless doctor visits. And everything includes one arena that often surprises caregivers: your sex life.

(Spousal caregivers, obviously, face even tougher challenges. See How Your Sex Life May Change When a Partner Has Dementia).

"Each situation tends to be specific, but caretakers often face some common challenges to maintaining a healthy sex life," says geriatric psychiatrist Ken Robbins, a senior medical editor who's also board-certified in internal medicine.

Here's what caregivers need to know about some common sex-life interferences.

Problem #1: Lack of sleep

"When caregiving interferes with sleep, couples have more difficulty getting along," Robbins says. "It's the number-one way that the stress of caregiving spills into sexual relationships."

What happens is more complicated than the fact that less time sleeping in bed equals less time for other activities there. Burning the candle at both ends to fit in all the extra chores of caregiving affects mood and patience. The more emotional and physical strain one endures without replenishment, the easier it is to snap. And snapping at your mate is, in turn, a surefire libido-killer.

A 2008 study found that dementia caregivers, in particular, got significantly less sleep than others. Alzheimer's and other forms of dementia often involve sundown syndrome, a behavioral state in which the person grows more agitated at night and, in some cases, doesn't settle down for hours. Many people with Alzheimer's confuse day and night, disrupting the sleep-wake cycle for the caregiver, too.

Problem solvers: Protecting sleep should be every family caregiver's main self-care objective. "It's in the interest of the entire household," Robbins says.

  • If you routinely get fewer than 6.5 hours of sleep a night, take a hard look at your schedule for places where you can cut back, delegate to other family members, or let go.

  • Try daytime naps, even if you've never been a napper. Enroll your relative in a senior center or adult day program several mornings a week so you can have downtime, or -- if you can afford it -- hire someone to come into your home a few hours a day, such as a professional elder companion (ask a local home health agency or personal in-home care agency for a reference).

  • If the person you care for has dementia, take extra steps to follow a predictable daily routine that includes movement and fresh air early in the day and time to wind down by evening.

  • Ask the person's doctor about medications (including some antidepressants) to manage highly disturbed sleep.

  • Consider whether it's time for an out-of-home living situation for an elder who's unable to sleep well at night.

Problem #2: Lack of privacy

Having a father or a mother-in-law right in the next room can crimp intimacy for those who are sensitive. But when a live-in relative thinks nothing of barging into your bedroom at all hours of the night or day, the problem moves from the psychologically difficult to the outright impossible. Some older people have a problem with boundaries or have cognitive impairments that don't let them discern what's inappropriate. Others, such as people with Alzheimer's disease, are prone to wandering.

Problem solvers:

  • As soon as a new living situation begins, discuss privacy limits with a parent who can still be reasonable: "Please knock before you enter our room, Mom." Do the same for her.

  • Install a deadbolt lock on your door; you'll still get interrupted, but at least you can control access.

  • Don't feel you should automatically put your parent above your spouse or partner; both need you. Often a parent's neediness morphs into emotional manipulation.

  • Look into plastic doorknob covers that are hard to grip to keep a wanderer in his or her room at night; install a baby monitor (in a location where the person can't see or reach it) so that you'll be able to hear if you're needed.

  • Consider hiring a night caregiver who can attend to the person at least a few nights a week.

Problem #3: The sandwich-generation blues

Taking care of the needs of both an aging parent and kids is a double-whammy for many mid-lifers. What gets squeezed out? You-time, me-time, us-time. When a woman doesn't have time to shave both legs at the same time or a man logs two jobs to make all the ends meet, it's little wonder their sex life sizzles a lot less than it did in their early days together.

"No matter how devoted you are to all the generations counting on you," Robbins says, "you have to have some opportunities to have your own life."

Problem solvers:

  • Rely on respite. Respite care provides a set number of hours each day or week when an older person gets out of the house and exposed to professionals who are expert at providing stimulating, interesting activities, both mental and physical. It's also an opportunity to socialize with peers. Using respite care isn't a bad thing; it's a win-win for everyone.

  • Reprioritize. Some couples find it helpful to take quarterly inventories of where they are as a team. Go out to dinner with an agenda, and make sure each shares candidly what's working and what's not, and then brainstorm strategies to get on track. The very act of making a commitment to yourselves can be transformative.

  • Go away together, by yourselves. It can seem hard to get away for a weekend if you can't even find an hour to have sex. But sometimes overstressed couples most need a complete time-out in order to remind themselves (and their bodies) what they're missing. Ask a relative to take over, or patch together on a combination of babysitters and respite.

  • Don't feel guilty about putting your marriage before others' needs. You have to have a healthy base before all the branches can flourish.

Problem #4: Depression

Caregivers experience higher rates of depression than the general population. Symptoms include lack of desire and difficulty falling asleep -- conditions that, obviously, wreak havoc over time on a healthy sex life.

It's worth noting that some treatments for depression can interfere with sex. The SSRI family of antidepressants (including Prozac, Paxil, and Zoloft) have been found in many studies to cause a dip in desire or in the ability to achieve orgasm -- not the effects you want if depression is interfering with your sex life in the first place.

Problem solvers:

  • Know the symptoms of depression for caregivers.

  • Don't hesitate to mention worrisome symptoms to your doctor -- and definitely mention your caregiving situation.

  • If you're diagnosed with depression, ask your doctor about a type of medication that doesn't interfere with libido, such as bupropion (Wellbutrin).

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

almost 2 years, said...

At last!! Thanks for this page. i'm so relieved to know that i'm not alone with caring for a loved one with Huntingtons desease with no sex for 5 years. God bless all caregivers out there!!!

over 5 years, said...

"When a woman doesn't have time to shave both legs at the same time." I never knew there were women with one shaved and one unshaved leg. I'll have to check this out. There are some things we guys will just never understand about women. Sad truth is, nobody wants us. I don't think I'll be reading caregiver romance topics again.

over 5 years, said...

I am 72 years old and considering moving my daughter into my home to help me out for my remaining, perhaps many, years. We'll convert the garage so we both have space. BUT my problem is not like what you are talking about. Much as I sympathize with the caregivers (I was my husband's for many years before he died of metastatic prostate cancer), I now have the opposite problem. My daughter is not in a relationship nor does she think she wants to be. I AM in a relationship, including plenty of sex! I'm the one who wants the privacy here. This may not last forever, but I don't want to miss out on even one of what my boyfriend (well, what do YOU call them?) calls "soirées". She understands this, but it doesn't really solve the problem.

almost 6 years, said...

Good to know that i'm not the only one with out a sex life. My situation's a little different than others here. I've been my wife's caregiver for over 22 years and married over 33 years. My problem is I wanted to divorce her before she got sick with multiple sclerosis. I stayed for my kids. She got sick while they were small and I spent my time working, taking care of kids and taking care of my wife. They are adults now and thankfully have their own lives. I want sex, I dream about sex, I just have no desire to have sex with my wife. I'm not in a position to be able to divorce her and place her in a care facility. I can't just abandon her. And even with as bad as I want sex I have no interest in sex with her after changing her diapers and cathing her multiple times every day I can't stand the thought of being intimate with her. My kids don't have anything to do with her, so i'm stuck. They suggest that I get a girl friend. But that is not easy to do. I'm 58 years old and am starting to feel like there's nothing to look forward to for the rest of my life. Quite a few people have suggested that I turn to the lord. Well i'm not that religious so I won't go there. I have also been online trying to find companionship. What I have discovered there is that the majority of the dating/hook up sites are scams and a waiste of time. So anyone know what is out there? I don't see anything hopeful at this point.

almost 6 years, said...

My lover is the only caregiver for his 87 year old mother. She is in relaticely good health but she frets being alone ,specially at night. This makes our sex life very difficult . I live 30 minutes away. When he spends our one weekly night together she makes him pay for it all the next day with accusations of abandonment. I love him dearly but fear this will be too much to bear over time. He is very devoted, a trait I admire. nontheless this causes me much pain. Any suggestions/ It took me months to convince him of the weekly night, but I feel I need more!

about 6 years, said...

i cared for my husband for 10 yrs and sex was out of the question, he was 100% VA handicapp, he had Agent Orange. Since his passing, I don't know how to go out into the world and start dating, I was so consumed with caring for him that it took all my energy, I had no life; it is so scary to think about dating at my age, I am still grieving. I am 61 yrs

about 6 years, said...

Excellent these were all key elements that I encountered with one more citicle piece -Diet I started eating foods that Dad would like, not me so much, then when we was nauseauted I would eat cold food, peanut butter and jelly...then I would not eat anything major because there was so much to do and I would not leave him or go far, and then there was the dying process which was about 6 weeks and I was too tired to care!

about 6 years, said...

good piece. Thank you

over 7 years, said...

all are facts which cannot be factored l really appreciate the work you are doing

about 8 years, said...

I feel like I am single,I'm 61 taking care of my spouse that was diagnosed 6 years ago with early onset Alzheimers. She has not had sex with me for 5 years and she is now in a nursing home. I miss the companionship and effection we used to share. I love her dearly, but I do miss the touching, feeling etc we used to share. It is really tough to be a caregiver when it is your spouse and she does not even remember when you come to visit her. God bless all us caregivers.

about 8 years, said...

I've been caring for my husband who is 25 years my senior. He had cancer but seems to be in remission now. He is feeling better after surgery (one month ago) and he wants sex. I have turned off that switch in my mind. He has asked me if I am having sex with someone else - which I am not. I don't want to hurt him, but I don't know how to explain my fear of hurting him - I cannot even hug him without him being jumpy and making sure I don't touch him in the wrong spot. I don't know how to get my sexuality back.

about 8 years, said...

I wish I could agree with you that a sex life takes back seat to caregiving family. Practically, it does kill passion and spontaneity - everything has to be planned. Buzz kill. But sex is a vital part of life, and makes you a whole person. You can substitute or compromise for just so long - I'm sure even vows of celibacy were broken in thought if not action. Thank goodness I have pets I can cuddle and love as a substitute for human love and affection. I've had more than one physician chastise me for my lack of sex, and worse my not even caring about sex. It's the latter that speaks volumes about individuals denying and repressing a human need for some "greater cause". At this point, I am so empty I really have no explicit feelings for my father, who I care for at this point. He is a chore, a responsibility, a stressor and reason I've lost my job ..."love" has been replaced by a million other feelings, and when he's gone, those will be replaced by relief.

about 8 years, said...

This is a sad and trajic topic. I would rather take care of my family members, than have a sex life. Sex is fleeting, while family is not. I gave up my sex life many years ago. Being a caregiver is no simple task. The Doctors here started a topic, which there is no simple answer for.

about 8 years, said...

My sister and I take primary responsibility for our Mother and Father as our brother is only available when it is convenient for him... Our Mother is in a nursing home with dementia and is in another world. She is very well taken care of and is happy, wherever she is...however, it is very difficult to see her and we make fairly frequent visits to check in on her. Even though she is in a nursing home we still must keep up with her care and make our presence known. Each visit is very stressful to say the least and it really does "wear on you"... On the other hand, our Father resides in "independent living" in a one bedroom apartment in the same complex. However, we really aren't sure how much longer he will be "independent" as we pretty much do everything for him. He does not drive so it is up to us to transfer him to/from the many doctor appointments which include the VA. Not to mention his grocery shopping and many other errands. He is becoming very forgetful and calls us randomly about things that happened weeks ago. We have discussed having him live with us but we are very, very hesitant because we really don't feel this is the answer. The next step is to go into assisted care and he isn't one to accept that and will be a bear to say the least. We don't see any light at the end of the tunnel for quite some time. So, to agree with the previous message...since we haven't had sex lives we have become Saints as we don't have any time for anyone else not to mention ourselves! I hope that I do not cause this kind of stress on my own children, just pull the plug...