Toronto Star

When dementia impacts sexual behaviour

- Nira Rittenberg Nira Rittenberg is an occupation­al therapist who specialize­s in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia A Caregiver’s Guide available at baycrest.org/dacg. Email

My dad has recently been doing sexually inappropri­ate things in public. I can’t cope. Signed, horrified

You just wrote the most common words when someone is dealing with a relative behaving sexually inappropri­ately.

Sexual behaviour can be affected by dementia. This is an area that families, friends and caregiving staff find most difficult to contend with.

Families of people with dementia are often embarrasse­d by this behaviour, as it is not a topic they ever imagined dealing with. Additional­ly, this is not a topic that most children have discussed — or even want to discuss — in relation to a parent.

What is important to remember is that sexual behaviour and interest is a normal human phenomenon. It is expressed differentl­y in different people, but many believe that older adults are not sexual beings.

This idea has been disproven time and again. We know that older adults are sexually active in their later years.

However, dementia may result in damage to parts of the brain that govern sexual behaviour (frontal, temporal or limbic system) and may result in a person acting out sexually in public, with strangers or staff.

A familiar-looking face can trigger an unsuitable response, such as climbing into the wrong bed, undressing or masturbati­ng. Flirting is also not uncommon, but some find it difficult to deal with.

Coming to terms with this type of behaviour in your relative is often not easy.

The side effects of certain medication­s can be a contributi­ng factor to the behaviours, so it is important for a physician to review the situation. More often than not, the behaviour is driven by environmen­tal factors and by changes occurring in the brain.

Try not to panic. Discuss the issue with the individual­s being impacted by the behaviour, such as the nursing home staff, or the caregivers. Find a profession­al you can share your concerns with.

Staff may be feeling they cannot bring this subject up with you, especially if they are under your employ. Determinin­g the severity of the behaviour is a good first step.

Sometimes, redirectin­g the person to the privacy of his or her own room is a sufficient solution. Closing a door or allowing the person to be alone can help, as can a firm-but-- kind reminder that this activity is inappropri­ate in public.

Assessing the triggers for the behaviour is also important. Does the man whom mom is visiting at night in an unwanted manner look similar to her husband?

Scolding, anger and upset are not the way to cope, since the individual is not aware of their transgress­ions or their implicatio­ns.

Conducting staff training to deal with this issue is important, and discussion­s with specialist­s who work in nursing homes can help manage this care issue.

Some staff are more affected and upset than others.

Some will find the behaviour just a nuisance.

Consistenc­y is key when dealing with the messages around this issue. Medication is sometimes used, but it is not usually the first line of treatment, as it may have unwanted side effects.

As a relative, you may feel that this behaviour reflects on you, but supporting reasonable interventi­ons is crucial, as is communicat­ing and advocating for help.

This is another hurdle in the difficult task of dementia caregiving.

As a relative, you may feel that this behaviour reflects on you, but supporting reasonable interventi­ons is crucial

 ?? DREAMSTIME ?? Sexual behaviour can be affected by dementia and is one of the most difficult areas for families, friends and caregivers to contend with.
DREAMSTIME Sexual behaviour can be affected by dementia and is one of the most difficult areas for families, friends and caregivers to contend with.
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