Written by Betina Lassen, specialist in dementia and psychiatry, Marte Meo- and occupational therapist
Dementia, sex and taboo
Elise looks over at her son Egon with a mischievous smile, then walks into the room next to the one where their family party is taking place. When she returns, she whispers to Egon that she has now taken off her panties so he can play with her during the family party. Egon looks at his 74-year-old mother, who has never said such a thing before, in wonder. She has always been a very shy, nice and polite woman. He thinks it must be due to the development of her Alzheimer's disease (a form of dementia), which has removed her inhibitions, just as the dementia consultant had told the family could happen.
Dementia and changed behaviour
As described in part one, there are several ways in which a hidden kink can show itself during a dementia episode. There are also several explanations for what may be behind the changed behaviour. For example, it may be due to:
- unfulfilled desires
- repressed needs and desires
- difficulty in expressing needs for intimacy, love, touch, sex, etc.
- difficulty separating fantasy from reality
- difficulty in perceiving the boundaries of others and oneself
- difficulty remembering what is proper where and when
- difficulty recognising who they are with
In order to find the best possible solution, it is naturally necessary to get as close as possible to the underlying cause. This will make it significantly easier to find a solution that will improve the quality of life for all parties.
Do we always have to do something about the new behaviour?
The solutions described will be particularly relevant if it is your partner who has dementia, but if you are another relative experiencing the challenges, you may also find inspiration to finding a solution.
The solution will also depend on whether anyone feels bothered by the new side of the person. Some relatives find the new behaviour liberating, just as some see it as a renewed energy for their lives together.
It is important to point out that although it is a change, for some it can be a wonderful change that can bring new and wonderful experiences to their lives. Therefore, the solution for some may be to delve deeper into what the kink is and whether it is something that their partner wants to be a part of.
Here, some choose to allow their loved one with a blossoming kink to live it out, either with them or with others with the same kink. There are also those who choose to invest in the sex toy that their partner wants, so that it can become part of the experience. However, it's important to really determine if it's something you want to be a part of, as it's perfectly fine to try and resolve it in other ways.
Solutions for creating intimacy
So, the solution depends on the underlying cause and desire. However, it should be noted that if what you are trying first does not work, then you should try to find another cause or solution. The person with dementia or a brain injury will in some cases have difficulty telling you exactly what it is they are trying to express with their actions, and they may have difficulty expressing their own needs.
It may be that the person is trying to tell you that there is something they are missing in life. It could be that they need an increased sense of presence and love.
There are many different ways in which people experience the feeling of being loved, and therefore there are several solutions. Often, the solution can be found by examining their lived life to see how they have had their needs met in the past.
It may be that:
- You need to do more meaningful things together, e.g. go for a walk together, go to the cinema, work in the garden, go to the swimming pool etc. Here it is important to consider what the person has spent their time doing in the past, as this may give an indication of what they experience as meaningful.
- You must help them with things in everyday life, such as helping them mow the lawn, bring the firewood in for the fire place, fix the fridge, vacuum or something else entirely. However, it is important to remember that some people find it difficult to ask for help, so it may be an idea for you to suggest doing it for them yourself, instead of waiting for them to ask. Then they can do something else in the meantime, like have a couch day.
- You need to touch them more e.g. through massage, holding hands, lying naked together in bed, taking a bath together etc.
Solutions to provide support in everyday life
Some people find that their relatives with dementia have a hard time determining what type of behaviour is appropriate in a given situation. By supporting and guiding them in determining what is expected in a situation, you will help them have a better experience. Here it will be good to:
- Distract them from the action the person is doing, if it is inappropriate.
- Try to involve the person in the given situation so that the person feels like a part of the community.
- Help them leave the situation before it develops into something negative. This will ensure that the person with dementia avoids losing face.
- Clearly tell them what is expected in the given situation e.g. "now you have to sit here and eat with the rest of us", "you're going to stay by my side while we go to the amusement park", etc.
Solutions for unfulfilled desires and repressed kinks
Some people have repressed their desires throughout their lives, as they have learned that it is not "respected" or "proper". That's why it's difficult when they get an illness that prevents them from curbing it - at least in the way they used to.
Here the solution depends very much on what the partner is willing to do and whether you as a partner are interested in exploring that side of yourself too. For some, the solution may be to get more sexual aids such as vibrators, butt plugs, dildos, penis sleeves, floggers, breast clamps etc.
It is important to point out that you as a partner should only participate in these things if it does not cross your own boundaries. Therefore, it is essential to go slowly and only participate in the things that you find exciting to be a part of. Having said that, some people experience a fantastic boost in their sex and love lives because they get involved in their partner's new-found kink.
If you don't want to become part of their changed sex life, then you might consider getting them involved with a masseur, a touch therapists or something similar to see if the need can be satisfied through these experiences.
Solutions if the person has difficulty separating fantasy from reality
Some people with dementia have difficulty separating their waking life from what is happening in their dreams or imagination. Here it may be a good idea to tell them clearly as they wake up that now they are up and need to get ready for the day to start.
By creating a clear start to the day or after a nap, it creates reassurance and predictability for the person with dementia. For some, this could reduce the difficulty they have in separating their dream state from their waking state.
Important points to remember
The important thing to remember is that it is difficult to change other people, even if they have a brain injury or dementia. The best you can do is also to adapt, to have a different experience of the other person or have a different reaction to their behaviour.
If you have any problems that you feel are taking up a lot of your private life, it is a good idea to talk to therapists and professionals such as your own doctor, a priest, a government dementia adviser, sexologist, psychologist or a psychotherapist.
It is essential to remember that it is possible to find a solution without involving medication - however, sometimes it takes many attempts before a solution is found. It is also often the case that the solution that works today is not necessarily the one that will work in some weeks time.
Read also: The blossoming of the hidden kink part 1 - on dementia and taboo
Read also: Sex and intimacy when you get older