Dear Family Advisor

My husband's dementia causes him to make sexual advances toward others -- and it's turning me off from wanting to be his caregiver.

My husband was recently diagnosed with dementia. But already he's begun sexually inappropriate behavior that's a 360-degree change from the man I married. He acts out in stores to strangers and at home to other women in the family. It's devastating me and hindering my desire to continue caring for him.

I could tell you all day that it's the disease (whether Alzheimer's or another cause of dementia) talking, not your husband, but I think much of what you're experiencing is grief. We think of grieving as something we do after our loved one has died, but grief comes into play any time life or a relationship changes so much that the old way has essentially died. In many ways, you probably feel, your marriage and your husband are gone.

Sexually based outbursts and behaviors aren't unusual for those with dementia, including Alzheimer's. It's the brain getting "stuck" in one area that it's hard to get out of. Knowing that this is common (and nobody's fault) may help you feel less alone. His behavior in no way reflects on his character or your marriage. All of us have inappropriate thoughts rambling around in our heads that we're able to control -- but what if we couldn't? Wouldn't we want our loved ones to forgive us and help us?

You can either let it get to you or you can slowly learn to sort of "float above it." Tune it out, divert, correct, and then try your best to laugh at the craziness of life. This may come over time after you've gotten used to his bizarre behavior and learned how to manage it.

Not least, I hope you'll find a safe, quiet place and allow yourself to cry "”- or scream, whatever you need to do to begin to process all the changes you've been experiencing, and will continue to experience. But don't isolate yourself because you're embarrassed. It's easy to pull in to try to protect our loved ones, but we hurt ourselves in the process.

You may indeed need to relocate your husband to a care home at some point. As you learn how to cope with the behaviors this disease causes, you also need to use this time to collect support and information about alternatives. As his wife and now caregiver, you can't stop; you can only pause to collect yourself.

Now let's get practical about the immediate problem. Dementia experts recommend several approaches when handling inappropriate behavior; try each to see what's effective with your husband.

  • Diversion is the easiest tactic. Change the subject, clap your hands, turn on the television or music, call out to someone across the room, ask a question "¦ anything that will disrupt his thinking (and mouth!).

  • Physically move your husband. Guide him away or, if he uses a wheelchair, move him to break the visual cues that are triggering his behavior.

  • Create space between your husband and other people. When you walk him into a room, create a safe barrier of space so that he can't "reach out and touch someone," especially if he's a "grabber."

  • Give him something to do with his hands. Some people with dementia crave textures, like furs, tweed, cotton. In later stages of the disease, for some people it works to hold a pillow, stuffed animal, or a blanket that has buttons sewed on it. Even a piece of Velcro he can smash together and then rip apart can help.

  • Matter-of-factly tell adults to excuse him. Some people choose to explain, "My husband has dementia," while others don't ---- that choice is yours. You can simply ask them to excuse his behavior or advise them to step back a bit, with a smile on your face and an easygoing attitude.

  • If nothing else works, "shock" him a bit. Raise your voice and firmly tell him, "No!" Grab his hands and put them back in his lap. Look him in the eye and let him know the behavior will not be tolerated.