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Perceived Sexual Behaviors in Persons Living with Dementia
One woman in the assisted living residence had to be watched closely so she didn’t take off her clothes—all of them. AFA social worker Melpo Voulieris, LMSW, who worked there at the time, said she had to educate the staff about what was behind the woman’s actions.
“Taking off clothes is not necessarily sexual,” she said. “As dementia progresses, impulse control may be impaired, and disrobing may occur when a person is no longer able to communicate certain needs—clothes may feel scratchy or uncomfortable, or the person may be hot or cold, tired, or even in pain.
In the assisted living facility, care partners and staff were careful to select more comfortable and less restrictive clothing for the resident and paid close attention to body language for any triggers that prompted her to take off her clothes. ”Sexual desires are normal for everyone, says Danuta Lipinska, MA, Reg.MBACP, a senior facilitator at a support program for care home managers in the U.K., but people with memory loss may have forgotten how to handle them.
“As dementia progresses, for some people there is less awareness of what constitutes private information and behavior. A lot of things trigger feelings of sexuality or lust. There’s not a lot of other stuff going on in their life. They may not feel they have much control over other things.”
Rather than trying to forbid habits like sexual gratification or looking at erotic material, Lipinska says to direct the person to a private place.
“It’s going to be difficult to shut that down. Things that were private are now in the public domain. It makes it really tricky, but there are things you can do.”
Keep in mind, often what seems to be sexual may be merely a need for companionship. “Behaviors that appear to be sexually motivated, in fact, may be something else but equally necessary for well-being,” Lipinska says.
If you are a caregiver who feels uncomfortable or threatened by some of this behavior, AFA suggests the following responses:
• Address the behavior when it happens.
• Avoid arguing. Tell the person in a calm and firm voice that the behavior is inappropriate, matching your body language to your words by frowning and shaking your head, but don’t shame the person.
• Wear clothes that indicate you are a professional, such as scrubs.
• Call the person by name or use Sir or Ma’am, not endearments like honey or sweetie.
• Keep a journal to help identify triggers and keep at a safe distance when possible.
• Provide alternative cuddling, such as a soft blanket, stuffed animal or doll.
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