Sexuality, Aging, and Dementia

Rector, Stephen; Stiritz, Susan Ekberg; Morley, John E.

doi:10.1007/s12603-020-1345-0

Cited by 4 publications

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…24 However, strikingly, these appear to be independent of the degree of impairment, age, gender, number of years of education, number of years of illness, or medication. [23][24][25]…”

Section: Sexual Activity In Dementiamentioning

confidence: 99%

The Expression of Intimacy and Sexuality in Persons With Dementia

D’cruz

Andrade

Rao

2020

Journal of Psychosexual Health

View full text Add to dashboard Cite

Sexuality in dementia is infrequently addressed. Dementia is characterized by a progressive deterioration in all domains of functioning, including loss of sexual function. However, the diagnosis of dementia does not mean an immediate or complete cessation of sexuality in the person, or a loss of the ability to consent to sexual activity with a partner. A discussion of sexuality in dementia occurs infrequently in clinical care for several reasons. These include (a) a discomfort in discussing sexuality in older adults, (b) the fear of causing social or cultural offense, and (c) the assumption that the cessation of the reproductive period implies the end of sexual life in older adults. There is also a tendency to focus on the preservation of cognition and independence, with relative neglect of the need for physical and emotional intimacy or quality of life. Patients with dementia are more likely to be sexually active than not. The most common change is a lack or loss or sexual desire. Inappropriate sexual behaviors occur in a minority of patients (28%) and can be usually managed with behavioral measures, with the use of pharmacotherapy for symptomatic management in refractory cases. Other clinical and ethical concerns in dementia include the capacity to consent to sexual intimacy, the formation of new relationships, sexuality in long-term residential facilities, and vulnerability to sexual abuse. Dementia care guidelines recommend a low threshold of suspicion for abuse, with a focus on patient safety. These must, however, be counterweighed by respect for patient autonomy and wishes.

show abstract

“…24 However, strikingly, these appear to be independent of the degree of impairment, age, gender, number of years of education, number of years of illness, or medication. [23][24][25]…”

Section: Sexual Activity In Dementiamentioning

confidence: 99%

The Expression of Intimacy and Sexuality in Persons With Dementia

D’cruz

Andrade

Rao

2020

Journal of Psychosexual Health

View full text Add to dashboard Cite

show abstract

The Law, Dementia, and Sexuality—Is the Law Striking the Right Balance?

Sorinmade,

Ruck Keene,

Peisah

2024

The Gerontologist

View full text Add to dashboard Cite

Background and Objectives English and Welsh laws require “contemporaneous” consent to sexual relations, often precluding “non-capacituos” people living with advanced dementia from these human interactions. Research Design and Methods The views of people living with dementia, carers, professionals, and over-55s were explored on implications of current laws on sexuality in dementia. 35 participants from England, were recruited through purposive selective sampling. Audio-taped semi-structured interviews were transcribed and thematically analysed, with each stakeholder group coded separately. Results Common themes across stakeholders were: (i) law reform needed due to their hammer-like effect ignoring the individual; (ii) dissonant theme of needing the law for protection; (iii) negative impact of denied intimacy on individuals and partners; (iv) support for Advance Decisions on Intimacy with caveats;(v) less support for involvement of Court of Protection and Powers of Attorney; (vi) call for review of capacity concept with support for an assent model. People living with dementia described shame and stigma associated with policing of their sexuality and perception of being singled out for protection and intrusion into their lives. For informal carers (mostly wives), the theme of “what about me” emerged, demonstrating that for the long-term partnered, this is a couple’s issue. Discussion and Implications Practical implications of this study include: need to address ageism and ableism; human rights education for society and professionals; starting point of presumed capacity for sexual relations with consensus on how and when this should be rebutted; care homes' certification requirements should incorporate assessment of the relationship health of their residents.

show abstract