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Alzheimer’s and Sexual Behavior: Appropriate Caregiver Responses to Inappropriate Behavior

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Alzheimer’s disease transforms a person’s behavior and personality. As the disease progresses, people with Alzheimer’s increasingly communicate through behavior instead of speech and their inhibitions can become reduced. In some cases, it can even bring about inappropriate sexual behaviors such as:

  • Making sexual advances to others
  • Undressing or touching themselves in public
  • Using vulgar or obscene language
  • Jealous accusations that a spouse is having an affair

This can be embarrassing for those close to the person with Alzheimer’s, but it can also be very confusing, distressing or frustrating for the person with Alzheimer’s as he or she most likely cannot understand why the behavior is considered inappropriate, nor remember not to do it again.

It is vital to remember that this behavior is a result of the disease — or possibly other health issues or medications — not a reflection of the person’s character.

This kind of behavior rarely involves sexual arousal. Sometimes what appears to be sexual is actually an indication of something quite different, such as:

  • Needing to use the toilet.
  • Discomfort caused by itchy or tight clothes.
  • Feeling hot from weather or an overheated room.
  • Boredom or agitation.
  • Forgetfulness.
  • Expressing a need to be touched, or for closeness, security, acceptance or affection.
  • Misunderstanding other people’s needs or behavior.
  • Mistaking someone for their current (or previous) partner.
  • Time of day. The person may simply want to get ready for sleep.
  • Depression, medication side effects or interactions.

If a reason for the behavior is not evident, here are appropriate responses to try:

  • Redirect the person to a meaningful or favorite activity such as listening to the radio or looking at family pictures.
  • Be consistent in promptly directing the person to a private area if he or she begins to undress in public.
  • Respond to feelings of rejection, loneliness or a need for closeness with gentle talk, a caring pat or a hug. Establish a balance; over-responding may encourage unwanted sexual behavior.
  • Try increasing the amount of exercise or activity the person gets.

Consider practical solutions; for inappropriate disrobing, buy special clothes designed with fasteners in the back for this specific reason, or try putting trousers or dresses on backwards.

When responding to an inappropriate behavior:

  • Respond calmly and matter-of-factly. Avoid becoming angry at, arguing with or embarrassing the person; try to be gentle and patient.
  • Don’t over-react, shame or ridicule the person.
  • Start to look for a solution, whether it is a different setting that does not allow for the behavior to be a cause of concern, some adaptive clothing or devices that prevent or reduce possibility for another occurrence

Share your concerns with a care professional who can provide additional suggestions. Careworks Health Services trains family caregivers in successful Alzheimer’s problem behavior strategies. We also employ professional caregivers who are skilled in the art of patient Alzheimer’s care and can give family members respite to relieve stress and care for themselves.