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Dementia and Sexual Relationships

How does the diagnosis of Dementia or more specifically of Alzheimer's Disease impact the intimate relationship between patients and their partners? Many couples are too embarrassed to ask the questions they really need answered.

For some sex is a non-negotiable need.Many couples find it beneficial to have a discussion, soon after the diagnosis, about their individual expectations. navigating this territory can be murky. Decisions should be based on what works for both people individually and as a couple.

A dementia diagnosis not only introduces other sexual issues it can also excaberate existing problems. As a person's cognition changes, so do the ways in which they relate to their partner.

The ebb and flow of dementia symptoms can create tension in and out of the bedroom:

  • A person with dementia may not always recognize his or her partner, and may respond inappropriately to verbal or physical cues.
  • Personality changes can mean a person who was once meek may be more aggressive or vice versa.
  • Dementia patients may make sexual advances toward strangers or forget their marriage vows.
  • Mistaking a relationship with one's partner in not uncommon. For, example, a woman could think her husband is her father, deem his advances inappropriate, and, react accordingly.
  • Proper sequencing, something that is primary to both sex and intimacy,deteriorates with Alzheimer's.
  • The unspoken language of a couple becomes disjointed. Partners often express a desire for sex in nonverbal ways, but these subtle cues may not be picked up or understood buy someone with Alzheimer's.
  • It's not just the couple's sex life that may suffer as a result, but any sustained form of intimacy.

For the partner without dementia:

  • During the sex act, dementia related symptoms such as limited attention span and lack of focus can make the partner without dementia feel unsatisfied,poorly treated or used.
  • Some partners wonder if the person with dementia can give informed consent for the sex act.
  • A partner without dementia can misunderstand what occurring: For example, a person with dementia might undress because his or clothing feels uncomfortable.

In the late stages of Dementia:

  • Intercourse usually isn't possible due to physical constraints.
  • The agitation often experienced by late-stage Alzheimer's patients can sometimes be alleviated by gentle touching and soothing words.
  • The sexual parameters of this part of the disease course primarily encompasses a softer form of physical comfort rather than more intense sexual encounters.

In skilled nursing facilities:

  • Workers generally aren't trained to see residents as sexual beings.
  • Innocent interactions such as snuggling fully clothed with one's partner can be met with dubious stares or outright chastisement.
  • Residents and their partners are accommodated by some facilities around the country.

Communication is complicated when the person without dementia acts as both caregiver and a partner. The duality of roles can be difficult, troubling, and for some, seemingly impossible.