Sexual urges don't necessarily disappear because someone has dementia. This can be a source of comfort and pleasure to some couples -- and a source of angst and confusion for others, including paid caregivers and others at whom the advances are directed. Both reactions are perfectly natural.
One particular source of distress for caregivers can be hypersexuality, when someone with dementia talks about and acts on sexual urges in frequent, inappropriate ways. Hypersexuality happens because of a loss of impulse control, a lost sense of what's appropriate public or private behavior, or because of difficulty in reading others' emotions.
Five things that help:
1. Provide extra reassurance and physical attention. Try snuggling while watching TV or listening to music; give extra hugs or massage (back, shoulders, body, foot, hand); do a little dancing.
2. Provide cuddling alternatives. For some, a blanket or stuffed animal to pet discharges some of the need to touch.
3. Insist on firm boundaries. Don't inadvertently encourage inappropriate fondling by allowing it even briefly one day and then reacting with indignity the next. Better to be consistently firm: "No, I don't like that." "That's not right."
4. Match your body language to your words. People with dementia are better at reading nonverbal cues. So frown and shake your head.
5. Realize that boredom can also be a root cause. Sexual activity can be almost an automatic response when there's nothing better (more distracting) to do. Make sure the person spends time moving and engaged during the day.
In extreme cases, talk to a doctor about medications that can help.
Learn more about how your sex life can change when a partner has dementia.