How Does Dementia Affect Sex and Intimacy?

The warm hand in yours, the soothing hugs, the shared laughter, the quiet comfort of simply being together — everyone knows that feeling. Intimacy is the glue that binds relationships, a silent language that speaks volumes. But when a dementia diagnosis enters the picture, this familiar comfort of love and connection starts to shift.

Explore the different ways to navigate these changes with empathy, understanding, and a commitment to keeping the embers of intimacy glowing.

Dementia and Sexuality

Dementia doesn’t have to be the end of a fulfilling intimate life. Many couples find ways to express closeness in new and meaningful ways. However, it can lead to significant changes in sexual behavior and desire because dementia affects the brain, and the brain is deeply involved in regulating our sexual behaviors and desires. Some people with the condition might experience an increase in sexual desire, while others might lose interest in it.

For example, a person with dementia might start to behave in ways that are out of character, such as making inappropriate comments or advances. Such actions can be confusing and embarrassing for both partners. But these behaviors are triggered by the disease and aren’t a reflection of the person’s true feelings or character.

Other times, a loved one may lose interest in sex. They may not remember their spouse or feel the same connection they once did. It can be incredibly painful for the partner who may feel rejected or unloved. Communicate openly about these feelings and seek support from healthcare professionals who can offer guidance and resources.

Intimacy and Dementia

Intimacy isn’t just about sex — it’s about closeness, affection, and emotional connection. Unfortunately, dementia can affect these aspects of a relationship, too. As the disease progresses, the person might struggle to remember shared experiences or recognize their partner, creating a sense of distance and loss.

Dementia can make expressing feelings verbally difficult, but there are still plenty of ways to show you care. Holding hands, cuddling, and sharing meaningful conversations can help maintain a sense of connection. Even if the person with dementia forgets specific details, the feelings of comfort and safety these actions provide can remain.

For instance, a couple might find new ways to enjoy each other’s company, like listening to music together or taking short walks. Simple, shared activities can foster closeness without the pressure of remembering the past.

Changes in Sexuality and Intimacy with Dementia

Unfortunately, changes in sexuality and intimacy are inevitable as dementia progresses. These shifts can vary widely depending on the type and stage of neurological conditions, individual personalities and relationship dynamics.

Two changes that might happen include:

• Increased Sexual Desire: In some cases, dementia can lead to hypersexuality, where a person exhibits increased sexual behavior. One study reports hypersexual behavior in 17% of out-patients with dementia and 8% of in-patients. Inappropriate actions can be challenging to manage. It’s crucial to set boundaries and seek professional advice to handle these situations sensitively.

For example, a loved one might start to undress in public or make sexual advances toward strangers. Such behavior is a disease symptom. Talk to a healthcare provider to find strategies to manage these negative outcomes effectively.

• Decreased Sexual Desire: Conversely, some individuals might lose interest in sex due to a variety of factors, including changes in the brain, medications, or physical health issues. For the spouse, this loss of sexual intimacy can be painful and isolating.

In these situations, communication is key. Discussing feelings openly and seeking professional guidance can help couples or family members navigate this change. Counseling or support groups for caregivers can also provide valuable insights and emotional support.

Sexual Health and Dementia

Maintaining sexual health is an important aspect of overall well-being, even for individuals with dementia. Here are some considerations to keep in mind.

1. Physical Health

Dementia often coexists with a health issue that can affect sexual health, such as cardiovascular problems, diabetes, or arthritis. These conditions can affect sexual function and desire. If a partner is experiencing pain or discomfort during sex, it might be due to an underlying health issue. Addressing this factor with regular check-ups and managing the conditions can help improve their overall quality of life and sexual well-being.

2. Medication Side Effects

Many medications for both dementia and related conditions can have side effects that may affect sexual function. These may include decreased libido, erectile dysfunction, or vaginal dryness. Talk to a doctor if a loved one is experiencing any of these symptoms. Sometimes, adjusting the dosage or switching pills can help

3. Emotional and Psychological Health

Dementia can lead to depression, anxiety, and other emotional changes — all of which can affect sexual desire and intimacy. That’s why it’s important these mental health issues are also addressed. Therapy, counseling, and medication can help manage these symptoms and improve overall well-being.

For example, if a person is feeling depressed, they might not be interested in sex. Treating their psychological disorder can help improve their mood and, consequently, their interest in sexual activities.

4. Navigating the Changes Together

Dealing with changes in sexuality and intimacy when a partner has dementia requires patience, understanding, and open communication. Here are some tips to help navigate these changes.

• Keep communication open: Be honest and talk about feelings and concerns openly. Both partners need to feel heard and understood. If verbal communication becomes difficult, non-verbal cues like touch and body language can also convey affection and understanding.
• Seek professional help: Don’t hesitate to seek help from professionals — be it from healthcare providers, counselors, or support groups. They can offer practical advice, emotional support, and resources tailored to your specific situation.

Talking to a doctor or therapist specializing in brain disorders can be a tremendous help. They can guide and support you when navigating these shifts. Several online resources and support groups are also available. Here are a few to get you started

• Alzheimer’s Association
• Dementia Society of America
• The National Institute on Aging
• Adapt and find new ways to connect: Be receptive about finding new ways to connect emotionally and physically. It might mean focusing more on non-sexual forms of intimacy, like spending quality time together, showing affection through touch, or simply being present with each other.
• Be patient and compassionate: Remember, changes in sexuality and intimacy are symptoms of the disease and don’t reflect the person’s feelings. Be patient and compassionate with your partner and yourself to maintain a loving and supportive relationship.

Approach Changes in Sexuality and Intimacy Positively

Dementia brings with it many challenges, and changes in sex and intimacy are among the most personal and profound. Understanding these changes are part of the disease process can help both partners manage the situation with empathy and compassion.

Open communication, professional support, and a willingness to adapt can help maintain a sense of closeness and connection, even as the disease progresses.

By focusing on the emotional and physical aspects of intimacy that are still possible, couples can find new ways to keep their bond strong and support each other throughout the journey. It’s not an easy path, but with love, patience, and understanding — it’s possible to find moments of joy and connection along the way.

Finding the Right Dementia Professional

Senex Memory Advisors have certified staff who collaborate and guide you every step of the way. Our proprietary tool Senex Saver allows our memory care advisors to thoroughly evaluate your loved one's health condition to determine their level of care before exploring the community options. We offer a structured and memory care placement process that will free you from the stress, overwhelm, and anxiety of having to do it all on your own.

We offer virtual consultations, making it easier for you to connect with a qualified dementia care professional regardless of where you live.

Remember, you are not alone on this journey. Senex Memory Advisors can be your trusted guide. With their expert advice, support, and resources, you can navigate this process with greater confidence.

Syed Rizvi

Syed has years of experience dealing with people, understanding their needs, and helping them find solutions to their problems.
As a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), Certified Montessori Dementia Care Professional (CMDCP), Syed is committed to working closely with Senior and their family knowing what is it like for individuals facing a challenging time, at times groping in dark trying to figure what is the appropriate next step or care level for their unique situation.
Syed and Senex Memory Advisors are fully committed to working closely with families in creating a personalized, step-by-step process memory care plan at zero cost.