Sexuality & Intimacy in Dementia Care

Sexuality and intimacy are fundamental human needs that persist throughout our lives, including into older adulthood.

For individuals with dementia, these needs often remain, though the ways they are expressed may change as the disease progresses.

Sexuality

• A natural and lifelong aspect of human existence.
• Encompasses sexual desire, identity, gender roles, sexual orientation, pleasure, intimacy, and expression through physical and emotional connections.
• Sexuality in long-term care settings may include actions such as:
• Affectionate touch (e.g., holding hands, hugging).
• Giving compliments or expressing care.
• Physical contact or intimacy, including sexual activity.

Intimacy

• The giving and receiving of love, affection, and emotional closeness.
• Includes caring touch, comfort, and a sense of safety in relationships.
• Intimacy remains important at every age and stage of life, including for individuals with dementia.

Sexuality and Dementia

A dementia diagnosis does not eliminate a person’s need for intimacy, companionship, and loving relationships.

However, dementia can impact how sexual and intimacy needs are expressed:

• Changes in memory, reasoning, and communication may result in behaviors that are misinterpreted as sexual.
• These behaviors are often not sexually motivated but stem from unmet needs or frustrations the person cannot articulate.

When encountering behaviors that appear sexual:

Look Beyond the Surface

Behaviors may be expressions of:

• Loneliness, boredom, or discomfort.
• A need for closeness, comfort, or security.
• Physical needs, such as hunger, pain, or needing to use the bathroom.

Assess what unmet need may be driving the behavior.

Avoid Misinterpretation

• A person pulling at their clothing may be hot or uncomfortable—not trying to disrobe inappropriately.
• Hugging or touching someone may be an expression of affection, not a sexual advance.

Maintain Respect and Dignity

• Intervene respectfully when behaviors are inappropriate or unsafe.
• Address the person’s underlying needs while preserving their dignity.

Promoting Healthy Sexuality and Intimacy in Care Settings

• Recognize the Individual’s Needs: Support safe and meaningful relationships. Understand that sexuality and intimacy are normal human experiences, regardless of age or cognitive abilities.
• Educate Caregivers and Families: Foster awareness and open conversations about sexuality and dementia without judgment.
• Provide a Supportive Environment: Ensure privacy for individuals expressing intimacy appropriately. Respect cultural, personal, and family values surrounding sexuality.
• Address Inappropriate Behavior: Intervene calmly, redirect the individual, and explore any unmet emotional, physical, or medical needs.

Sexuality and intimacy are integral to human well-being and do not disappear with age or dementia. By understanding the unique needs of individuals with dementia and responding with empathy and respect, caregivers can create supportive environments that honor these aspects of human life.