by Patricia Hunter
Each issue of Dimensions features an article contributed from an Alzheimer's related group in Washington State. This article is contributed by and reprinted with permission of the Alzheimer's Association --Western and Central Washington Chapter.
Alzheimer's disease affects marital or other intimate relationships in a variety of ways. Couples may experience changes in roles, loss of companionship, and difficulties with communication. Problems with intimacy and sexuality are particularly challenging for many couples. The person with AD may experience changes in sexual behavior that are difficult to understand, and caregivers may be reluctant to discuss these changes with their health care provider or other support persons.
Some common changes in sexual behavior associated with AD include:
It is important to recognize that since AD affects the function of the brain, changes in sexual behavior are caused by the disease, and are not a reflection of the person's character or feelings for the partner. It is also essential to understand that individuals with AD continue to need love, affection, and intimacy.
Sometimes, however, these changes are very distressing to caregivers. For example, the affected partner may make unreasonable requests for sex. For some caregivers, it may feel wrong to say "no" to these requests, due to feelings of obligation, culture, or feelings about marriage. Some caregivers may fear that saying "no" to a persistent partner may trigger anger or agitation. Alzheimer's can also cause an individual to forget how to be intimate, making him or her less considerate of the partner. Caregivers may feel used, unloved, angry, and frustrated, or may feel that their own needs are not being met.
Alzheimer's disease may also cause an individual to misinterpret situations or become suspicious. For example, a wife with AD may think her husband has a girlfriend and accuse him of going to see her, when he is really running needed errands. A phone call from a female caller, even if the caller is a relative, may cause a person with AD to become upset and accusatory towards the caregiver.
Alzheimer's disease may also affect the caregiver's own feelings about sexuality. Some caregivers lose sexual desire due to the constant demands of caregiving and to changes in their loved one. However, some caregivers find that sexual activity and intimacy become more important as their partner loses the ability to join in other activities. Physical contact in the form of hugging, stroking and touching communicates affection and may help maintain a sense of connection between the person who has AD and the caregiver.
If you are experiencing difficulty coping with your feelings about the changes in your loved one, an Alzheimer's disease support group or professional who understands AD and sexual issues can help. A detailed fact sheet about AD and sexuality is also available from the Alzheimer's Association, at 800-848-7097 or www.alzwa.org.
Adapted from "Alzheimer's Challenges in Couples' Closest Ties", Alzheimer's Association Newsletter Advances Summer 2001; Alzheimer's Association Fact Sheet, "About Sexuality" 2004. Additional information came from: Daniel R. Kuhn, LCSW, Alzheimer's Association Detroit Chapter, and Lore K. Wright, PhD, RN, CS.