How Dementia Changes Intimacy in Relationships

Memory loss leads to shifts in the brain, and it’s key to recognize the ways dementia changes intimacy, platonic relationships, and sexual relationships. This impact both people living with the disease and their partners.

Common Challenges

Many couples report a loss of intimacy due to less emotional connection, more conflict, and sexual dysfunction. The loss of intimacy can sometimes lead to romantic interests with other people. A new relationship may be started by either the person living with dementia or the care partner.

Cognitive changes can include confusion, social withdrawal, and a loss of physical function. Individuals living with dementia can lose interest in sex, or become “hypersexual. ” Behaviors such as masturbation in public or inappropriate sexual advances may occur.

We express love and connection to each other in a variety of ways. Intimacy can include spending time together, saying kind words, and through physical touch. People living with dementia, like everyone, need to feel loved and cared for. But as the symptoms of dementia progress, partners often find themselves pulling away.

Strategies for Coping

Care partners may find it helpful to find new ways of expressing love and commitment. And it is important to be aware that it takes time to adapt to the changing relationship. Here are some strategies that may help couples in coping with these changes:

• Find different ways to physically touch each other. Kissing, holding hands, snuggling, massage, or dancing can meet the need for touch. Keep in mind that helping with personal care may be an opportunity for physical touch and connection.
• Consider non-physical ways of connecting. Sharing stories, listening to music, or enjoying favorite foods together are all good options.
• Explore new ways of spending time together. Focus on enjoying moments rather than creating memories. New activities or new surroundings can provide opportunities for new interactions.
• Redirect unwanted sexual or physical contact. Use activities that provide touch or stimulate the senses. Try massage, scented lotion, or items to keep hands busy. Activities that keep attention focused elsewhere can also help.
• Consider ways to meet your own sexual or physical needs. Masturbation, regular exercise, and other forms of physical activity or physical contact may help.

Keep In Mind

• Despite dementia, satisfying sexual relationships are possible if both partners express consent. You may need to adapt your routines. Adjust your timing, frequency, intensity, or location to better suit your changing needs.
• Watch and listen for sexual behaviors that may be the person’s way of expressing an unmet need. Physical or emotional needs can include pain, boredom, or needing to use the bathroom.
• Reassure the person living with dementia that they are loved and safe. Using your words, facial expressions, and physical touch can be helpful in validating a person’s feelings or needs.
• It’s okay to take breaks from each other and spend time with other people. Cultivate friendships and other sources of emotional intimacy, companionship, and connection.

Get Support

• These changes are new and uncomfortable to you. However, professionals and other care partners are familiar with these types of challenges. Discuss these changes with a doctor, counselor, clergy, or other trusted advisors. You can also share your concerns in a support group.
• Contact Alzheimer’s San Diego for guidance, advice, or support groups.

Sources & Recommended Reading

• Family Caregiver Alliance
• Keeping Love Alive as Memories Fade: The 5 Love Languages and the Alzheimer’s Journey. Gary Chapman, Edward Shaw & Debbie Barr (2016)
• Ten Thousand Joys & Ten Thousand Sorrows: A Couple’s Journey Through Alzheimer’s. Olivia Ames Hoblitzelle (2010)

For personalized dementia support, call us at 858.492.4400 to speak with one of our Dementia Care Coaches who are here to help San Diego County residents and/or those caring for someone living in San Diego County (Spanish speakers available). Also check out our free education classes, social activities, caregiver support groups, & more.