Sexual problems associated with dementia: Part 1. Problems and their consequences

Abstract

SUMMARYSexual problems associated with dementia fall into four groups: problems involving an established partner, problems involving a new partner, problems occurring independent of a sexual partner (sexual acting out, inappropriate sexual talk, false sexual allegations) and sexual abuse. The whole area has received little attention despite the major consequences for patients, partners and carers.

Discovering the person with Alzheimer's disease: cognitive, emotional and behavioural aspects

“…Hope et al, (1997) suggest there are three distinct behavioural syndromes in dementia: over-activity (including aimless walking); aggressive behaviour; and psychosis (hallucinations, persecutory ideas and extreme anxiety). However, the elaboration of typologies of, say, wandering , aggression (Stokes, 1989;Ware, Fairburn, & Hope, 1990) and sexual problems (Haddad & Benbow, 1993) support the need for a multi-factorial understanding of such difficulties. Two people may both be said to 'wander', but the actual behaviour and its function may be quite different.…”

Sexuality and Older People: Revisiting the Assumptions

“…Rather, it should be interpreted as a broad range of physical acts, including intercourse, masturbation, fondling, kissing and hugging, as well as the warmth and tenderness of emotional intimacy (Haddad & Benbow, 1993). Many men, when released from rigid gender roles and the expectation of coitus, discover a variety of satisfying ways of expressing their sexuality (Datan & Rodeheaver, 1983).…”

“…Although there is little literature on sexuality and dementia, it has been recognized that dementia may lead to a wide range of sexual problems (Haddad & Benbow, 1993). Sexual problems often arise when one member of a couple develops dementia.…”

Improper Sexual Behaviors in Elders with Dementia Living in Residential Care

“…In a review, Haddad and Benbow [10] offered three categories: (1) problems with an established partner, where usual sexual behavior was compromised by a dementia; (2) problems with a new partner, where relations were complicated by the objections of interested observers (spouses, children or other carers); and (3) problems independent of sexual partners, which encompassed 'sexual acting out', 'inappropriate sexual talk' and 'false sexual allegations'. The first two categories focus on context, which leaves unclear how (or why) a specific behavior might qualify as improper or abnormal.…”

“…improper) or abnormal; some behaviors present as coarse derangements in which rudeness and aggression are prominent aspects [6][7][8] , while others, such as touching, cuddling, caressing or kissing, may seem innocuous to a casual observer [9] . Therefore 'inappropriateness' may derive from the disapproving attitudes and judgments of observers (clinicians, nurses and other staff, family, other residents) rather than the behaviors per se [10][11][12] , and may reflect the lack of privacy inherent in residential care environments [13] . Furthermore, as some argue, not incorrectly, individuals with dementia can express a normal sexuality [14,15] .…”