It may be jarring to hear your loved one suddenly begin talking about sex or acting in sexually inappropriate ways, but this Alzheimer’s symptom affects many people with the condition.

“Is hypersexual activity common in dementia patients?” one myALZteam member asked. Another replied, “Yes. It makes it hard to go anywhere with them, as you never know what they will say.”

Although inappropriate sexual behavior is relatively common among people with dementia, it can create challenges for caregivers and impact your quality of life. Knowing how to respond and when to talk to your loved one’s neurologist can help you deal with this type of behavior when you see it.

Know the Types of Sexual Behavior You May See

When someone with Alzheimer’s disease begins talking about sex or acting out in sexually inappropriate ways, it may be due to a combination of poor judgment, cognitive decline as the disease progresses, and personality shifts.

Some of the sexually inappropriate behaviors you may see include:

• Sexual conversations — This includes using crude words, talking about sex, and saying sexually suggestive things to family, friends, or people in public.
• Implied sexual acts — Those who ask for medically unnecessary genital attention or are obsessed with pornography would fit into this category.
• Actual sexual activity — Some people with dementia may openly engage in masturbation, expose themselves, begin undressing, grab their genitals, or reach for private areas on other people.

“We are having grave problems with hubby due to heightened sexual behaviors, inappropriate as well,” one myALZteam member wrote.

Another said, “My husband has started making sexual comments to waitresses.”

A third member responded, “A friend's husband was picked up for inappropriate sexual advances while at an event with his son. Police were kind and brought him home. This disease is cruel and bizarre.”

Sexually inappropriate behavior among those with dementia is more likely among individuals with severe cognitive impairment and people in skilled nursing facilities. A 2016 study found that, whereas women with dementia are more likely to verbally express inappropriate sexual behavior, men are more likely to act out physically.

These types of sexual behavior changes may occur in the early stages of dementia or could develop later due to worsening cognitive function.

5 Ways To Deal With Inappropriate Sexual Behavior

Up to 26 percent of people with neurocognitive disorders like Alzheimer’s disease may exhibit sexually inappropriate behavior, which means it’s important for every caregiver to know how to handle it. Consider employing one or more of these five tips to help when your loved one is showing these symptoms of dementia.

1. Try To Stay Calm

As surprising as it may be to see your loved one behave in a sexually inappropriate way, your best bet is to stay as calm as possible and not overreact. Avoid arguing with the person, and never shame them or laugh at them.

If the person has the awareness to understand you, it might help to explain why their behavior isn’t appropriate, but this may not be an option if their cognitive decline is too significant.

2. Redirect Their Attention

Try to turn your loved one’s attention away from the sexual behavior to focus on something else. If they are exposing themselves or touching their genitals or other people, try to move them away from where they are to refocus their attention. For instance, you may ask them if they’d like to join you for a cup of coffee or a walk to redirect their attention.

One myALZteam member wrote, “The only thing that might work is redirection. Often, what causes a behavior is some need. It could be that the person is feeling lonely, isolated, needing intimacy and feeling important.”

Another member replied, “The redirection really helped — thanks!”

3. Take Note of When It Happens

For some people with Alzheimer’s, certain sexually inappropriate behaviors may crop up at specific times of day or during certain activities. For instance, if your loved one tends to start talking about sex at sundown, they could be feeling restlessness that leads to sexual behaviors because they’re anxious or need sleep.

In other cases, the inappropriate behavior may occur when the person is bored. If your loved one starts acting hypersexually during periods between activities, consider asking if they’d like to talk, do a craft together, or have a snack. Take note of whether any of these suggestions help curb their behavior so you can try them next time.

If you notice that the presence of any particular person seems to trigger sexual behavior in your loved one — such as a fellow nursing home resident or home care nurse — try and ensure that they’re separated from that person in the future to potentially curb their inappropriate behavior.

4. Work on Self-Esteem Strategies

Some research indicates that people may act out sexually due to a loss of self-esteem. Individuals who understand that they’re losing their independence or cognitive abilities may show anger or other behaviors to act out, and this can include sexually inappropriate behavior.

In some cases, it may help to work with a mental health professional or a physical or occupational therapist who can help the person get back to doing some of the daily activities and tasks that they feel they’ve lost. By improving their self-esteem, the inappropriate behaviors may stop.

5. Talk to Your Doctor

If your loved one begins showing any new or troubling behaviors — including hypersexuality — you should talk to their neurologist. Your neurology team may be able to suggest medications or other types of interventions that can help curb their inappropriate behavior and take the stress off of you as the caregiver. Your loved one’s doctor might recommend antidepressants, antipsychotics, or other drugs, depending on the situation and the person’s overall health.

“It is a good idea to reach out to a doctor about this,” one myALZteam member wrote. “There are meds to lower sex drive and might be able to help avoid some potentially difficult interactions.”

Another member said, “My husband had bad hypersexuality. They put him on medication and it’s almost completely gone now. What a relief!”

Your health care providers may also have suggestions for other resources that can help. One member said that their dementia care team advised them to get specific cards from their local Alzheimer’s Association office. “These cards can be slipped to restaurant servers, etc., which say, ‘Please be patient’ and identify the person with you as having Alzheimer's,” the member shared. “They also say, ‘Thank you for understanding.’ I’ve used them a few times when the server looked perplexed.”

Talk With Others Who Understand

On myALZteam, the social network for people with Alzheimer’s disease and their loved ones, more than 85,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.

Has your loved one begun exhibiting sexually inappropriate behavior? How do you deal with it? Have you talked to a health care professional about these concerns? Share your thoughts in the comments below, or start a conversation by posting to your Activities page.