Written by Betina Lassen, specialist in dementia and psychiatry
Peter sits on the green sofa and looks at Alma, who is sitting in her black leather armchair with her knitting. The television is running in the background when Peter suddenly stands up, walks over to Alma, takes out his cock and says "Suck it", after which he grabs her hair and forces her head up from the knitting into a suitable position to give him a blow job. Alma is somewhat startled and looks up at her handsome 85-year-old husband, who was told 3 months ago that he has frontotemporal dementia. She has seen him change over the years, but she never saw this coming. They have always had a quiet and perhaps somewhat traditional sex life with sex every Saturday, often in missionary position, and when they wanted it a little extra naughty, he took her from behind. Alma was therefore a little scared of where this sudden impulse came from....
When people develop dementia, their personality will change as the disease progresses. For some, this can mean that they find it difficult to reduce or contain their urges. Therefore, for example, it can become difficult to inhibit the urges for kink, which they perhaps have previously learned to restrain. This kind of altered behaviour is also something people with certain brain injuries can have.
As the disease progresses, their memory of what kind of sex they have with their current partner may become blurred, so that the things they previously did with another partner or just in fantasy, are now what they think they have with the person they're currently with. It may also be the case that they have always put restraints on their desires and urges, having been taught early in life that these are forbidden urges and desires. Therefore, they have resigned themselves to the form of sex that has been deemed more mainstream.
As their illness progresses, the ability to inhibit their urges and desires will diminish or disappear altogether. As a result, some will find it difficult to restrain their urges. Then they may suddenly start masturbating in public or while sitting at a family party, or uninhibitedly sit and fondle you on your breasts in public places, which they may never have done before. They may also find it hard to separate what they see on TV or in porn, so they think it's something they've done with their partner and now want it to happen again.
The person with dementia may find that their needs are not being met and their partner may see this as difficult boundary-crossing behaviour. It can therefore end up in a gothic knot where both parties are unhappy, until they eventually get help to deal with it.
In the next section I will look at ideas for what can be done to help with these issues....