Hypersexual Behavior and Dementia: 6 Ways to Dissuade

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.

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 3 years, said...

This doesn't address the "instinctive" reactions that some people with dementia have. For instance, when attempting to assist with an ADL that causes a caregiver to be in a position that can give the person a sexual queue -- for instance, washing genitals or even the fact of being naked. These can cause an instinctive behavior, which should be addressed, yet not reprimanded. Also, when "lashing out" frustration by way of grabbing the caregiver's genetial areas should be handled differently than one who is thinking sexual.

over 3 years, said...

Yes, all your comments are welcome Paula! Lots of hugs are helpful to both partners.

over 3 years, said...

Great article, thank you. There is a new book on this important topic, "Sexuality and Dementia" by Dr. Douglas Wornell, that is the first and only comprehensive book on the subject. I highly recommend it, and review it here: http://www.caregivers.com/assisted-living/sexuality-and-dementia-book-for-alzheimers-caregivers/ --author, "Inside the Dementia Epidemic: A Daughter's Memoir"

almost 4 years, said...

Excellent tips. Readers might also want to check out the new book "Sexuality and Dementia: Compassionate and Practical Strategies for Dealing with Unexpected or Inappropriate Behaviors" by Dr. Douglas Wornell. It seems to be a comprehensive guide, with plenty of specific examples of situations a family caregiver might face. --author, "Inside the Dementia Epidemic: A Daughter's Memoir"

about 5 years, said...

Two years ago, my husband (now 71) was diagnosed with mild dementia, cause unknown. Maybe alcohol, maybe TIA. We had not had sex for the last 12 years. He had low testosterone, but prescription hormone make his PSA shoot up, so it was discontinued. I quit taking hormones myself . I had had hysterectomy/bilateral oophorectomy and needed them for both desire and lubrication. After I quit hormones, my desire disappeared as well, and I suspect intercourse would be very painful in my shrunken, dry vagina. However, out of the blue last week my husband began making sexual advances. I told him that 10-12 years ago it would have been welcome, but now I really feel nothing and that intercourse would be painful for me. His personality is not the same either, and I stay with him more out of duty than love. I know he couldn't get along without me, as he can't manage finances or medications on his own. I guess the kids could do it, but I don't want them to take on that burden unless I myself can no longer do it. I wish I could feel desire for him--or anyone, for that matter! But I can't.

about 5 years, said...

re: the use of the word "indignity" -- though, for the most part, the information in this article was helpful, and appreciated, the author's use of the verbiage he employed belied his intent. "Indignity" (n) was incorrect and inappropriate for his intended meaning. "Indignity" refers to be lacking in dignity; a state of being in which one experiences something injurious to one's sense of dignity. an injury to a person's dignity; a slight, malicious treatment or humiliating affront, insult, or injury. Literally, it means no (in) dignity, or to take away dignity. [Obsolete definition: disgrace or disgraceful action.] i.e.: He did not enjoy suffering the indignity of being chastized by someone so much younger and inexperienced than he; Oh, the indignity of it all. "Indignance," (n) or "indignant" (adj) on the other hand, refers to a "feeling that is characterized by, or expressing strong displeasure at something considered unjust, offensive, insulting, or base:" ("dictionary.com") i.e.: She was indignant at the rudeness shown by the teens; she was appalled at the level of indignance he expressed at such a small social slight.