Strategies for Managing Sexually Related Stress Reactions

Caring for individuals living with dementia can be challenging, particularly when their reactions become physically and/or verbally sexual in nature. Care Partners play a crucial role in creating a supportive environment that addresses the unique needs of the person living with dementia while maintaining dignity and safety for all involved. Here are some helpful tips and tools for care partners to keep in their tool box while helping people with sexually related stress reactions.  

Identify Potential Triggers

Identify potential triggers for sexual reactions, such as unmet needs, providing care, or environmental factors. Keep a record of when these reactions occur to recognize patterns and address them.  

Questions to ask: 

• What do you know about this person in your care? Is there a pattern of this type of reaction or is this the first time observed? 
• If there is a pattern, does it seem to be with the same care partner or with any care partner? 
• Observe what is happening in the moment? Even asking someone to get undressed may be misinterpreted.
• Are there visual or auditory cues in the environment such as a picture or something on the television that might trigger this type of reaction? 
• Are movies or music being played that might invoke memories or sexual thoughts? 

Use Effective and Dignified Communication

It's important to remember that the need for touch and human connection does not go away with a diagnosis of dementia. Respecting the person's basic human needs is important. 

Use clear, simple language when communicating. Be clear about what the intentions are for your visit and interaction. Visual cues can be helpful to indicate engagement in health-related care activities versus activities associated with intimate relationships. Be patient, allowing ample time to respond and avoid confrontational communication. Identify the feelings that the person might be experiencing. 

Tips!

• Clear and simple does not mean child-like or phrases that are demeaning.
• Wait to speak until you can see their eyes.
• The person is having a hard time, not intentionally trying to make you uncomfortable. 

Address Immediate Unmet Needs

Regularly assess and address physical and emotional needs, including the need for social interaction and sensory stimulation. They have the same desires and urges as someone who does not have dementia. Seemingly inappropriate reactions may be the only way for individuals with dementia to communicate their needs. Sexual behaviors and tal are normal and natural. 

Tips!

• Offer to give the person privacy if they are engaging in sexual acts in front of you and are aware of what they are doing. 

Know the Person in Your Care

Establish and maintain daily routines to provide a sense of stability. Know the whole person in your care, including their gender identity and sexual orientation. Caregiver consistency for certain tasks can be helpful. For example, the person goes for walks and plays games with their grandchild, whereas their spouse helps them with more private tasks like changing clothing or bathing. 

Tips!

• Maintain the same routines they have held when possible.
• Attempt to gather as thorough of a history as you can, including photos of the person's significant relationships. Having this information will be key in developing the most considerate care approach for them. 
• Think through current caregivers' physical appearance and adjust for unintentional triggers. 
• Sexual orientation needs to be considered and assessed for missed triggers. 

Create a Safe and Familiar Environment

Minimize environmental stimuli that may contribute to agitation or confusion. Ensure the living space is familiar and comfortable, reducing the likelihood of disorientation. Helping them to their favorite chair indicates to them that it's time to relax or take a nap, whereas laying them down in bed may cause them to respond more sexually. 

Tips!

• Ensure the TV or music is turned to a comfortable level and that programming is age-appropriate while respecting their preferences. Turning on mature content romance movies can cause unwanted triggers to occur. 

Interdisciplinary Involvement

Seek guidance from other healthcare professionals, including psychologists or neurologists, when these foundational approaches have been established. Collaborate to develop personalized strategies for managing specific reactions. 

Tips!

• Some reactions may be due to medication side effects, so it's best to communicate with the other care partners involved for the best possible outcome.
• Are reactions directed toward someone who looks like a significant other? If so, be mindful when this person is present and strategize for needed changes to social interactions. 

Caregiving for individuals living with dementia requires a compassionate and adaptive approach. By understanding triggers, maintaining routines, and implementing effective communication strategies, care partners can create a supportive environment that minimizes sensitive stress reactions and enhances the well-being of those under their care.  

These and other tips are included in AGE-u-cate's programs.  We invite you to learn more about empowering your care partners today!