Is it normal for my grandfather, who has Alzheimer's and dementia, to be acting inappropriately towards other people?

Queenconger asked...

My grandfather has mild to moderate Alzheimer's and dementia. Is it normal for him to be acting inappropriately around other people and making sexual advances towards his caregiver? What can we do to make this stop? Any suggestions?

Expert Answer

Beth Spencer is a social worker in Ann Arbor, Michigan, with more than 25 years of experience with families who have a member with dementia. She is coauthor of Understanding Difficult Behaviors and Moving a Relative with Memory Loss: A Family Caregiver's Guide. Previously, she directed Silver Club, early-stage and adult day programs serving individuals with Alzheimer's disease and related illnesses.

One of the things that happens sometimes in people with dementia is that they lose some of their social inhibitions, due to some of the changes in their brains. This means that their ability to distinguish what is or is not socially appropriate is no longer working right. This can manifest itself in different ways: saying embarrassing things to people, picking up a plate and licking it, or making sexual advances, for example. 

Sometimes a person who is making sexual advances is simply lonely or in need of affection. Also, he may think his caregiver is someone else, such as a spouse or someone from his past. 

  • It's not possible to reteach appropriate behaviors, usually, but there are some other things that you might try:
  • Make sure that your grandfather’s caregiver does nothing to tempt him, that she dresses and behaves modestly.  Sometimes the person with Alzheimer’s is misinterpreting cues.
  • Help her come up with some firm responses to your grandfather, such as, 'Mr. Smith, do not say that to me please.' Teach her to walk away from him when he behaves this way. It's important not to reinforce the behavior with attention.
  • Is there a particular time or place it is happening? During dressing or bathing, for example? If so, help the caregiver think about how to do these tasks in a very matter of fact way.
  • Switching to a male caregiver may make this problem disappear. 
  • If all else fails, ask his doctor about medications that may dampen his sexual ardor. This should be a last resort, however. It does not always work, can have unwanted side effects, and physicians are often reluctant to try this.