Dementia is an illness in which brain cells die more quickly than normal. As the condition progresses, memory loss and confusion increase.

There are likely to be personality changes and, eventually, the affected person will be unable to care for themselves. Dementia is permanent and irreversible.

The two main kinds of dementia are Alzheimer’s Disease and Arteriosclerotic (or multi-infarct) dementia. Dementia affects nearly 2% of people aged 65 to 70, 9% of those aged 70 to 80, and 20% of those over 80. Do remember though, this means that there is more chance that you will not develop dementia than that you will!

Dementia is likely to have an impact on the person’s sexual activity. Some degree of sexual difficulties, described elsewhere on the site, are likely to have developed earlier in life with people who suffer from Vascular disease.

You might consider talking about these things now when you are well. In this way, should the worst ever happen, your partner(s) will be aware of your wishes and will feel more confident and able to deal with any difficulties which arise.

The issues which a partner/carer may have to contend with include the following:

Interest in sexual activity may diminish or end entirely as the illness progresses.  If this happens, then a partner may find the loss difficult to deal with. It should be borne in mind however that other intimacy need not end and is likely to provide reassurance and comfort to both.

Should interest in sexual activity remain as before, then a partner may wish to continue with this also – there is no real reason why this should not happen. It can help to maintain normality and reassurance in both lives. Some people become concerned that this may be seen as exploiting a vulnerable person since they are not giving the same level of Consent as before. However, if the person with dementia does not wish to engage in sexual activity, this will become apparent and the partner can change behaviour accordingly.

The situation can also arise that the partner no longer feels able to engage in sexual activity with the person. This can happen where a personality change has taken place and it no longer feels like the same person anymore. Where the partner is also a carer, providing this care can be so tiring that all interest in Sex wanes, or the personal care which has to be provided may be off-putting to further sexual contact. It is important not to feel guilty about this. Such difficulties may be overcome with supportive services taking on more of these roles.

Where there is an increase in interest in sexual activity, perhaps as a result of a loss of Inhibition generally, this can be distressing for a partner. The new level of interest may now exceed that of the partner, who may feel unable or unwilling to match it. These are issues which can be found in other relationships which do not involve dementia, and may to some extent be dealt with in the same way. Nobody should feel obliged to engage in any activity which they do not wish to.

There are difficult decisions to be made in such situations and discussing them with your partner may no longer be possible. Someone else may help you through the process. This can be with a friend, your doctor or a counsellor with a support organisation such as Alzheimer’s Scotland.

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