When I do it, it’s normal. When he does it, it’s because he’s a dirty old man…
I have heard the words "sexually inappropriate" in relation to people living with dementia more times than I can remember. In fact, I am sure that at some point I have said that someone I was supporting was being sexually inappropriate, and it’s possible that they were, but it is just as possible that I was misinterpreting someone else’s actions or was seeing them through my own preconceived notions of sexuality and older people.
Most of us did not think that older people were sexual when we were young. There is also a pretty good chance that as you have aged your thoughts and ideas about sexuality and ageing have begun to shift. As we age we gain insight into the complexity of our own sexuality and recognise that it is not merely a set of actions driven by hormones but it is about a complicated number of reasons including experiencing pleasure and often about making a meaningful connection with another person.
Sexuality is still a bit of a taboo topic, and ageing and sexuality is certainly not the great dinner party conversation starter that you might think. But we need to have conversations about sexuality and dementia in health and social care settings. Not just conversations about someone “behaving inappropriately” and “what are we going to do to make sure this doesn’t happen again” but honest conversations about how people express their needs, and whether those needs are sexual or are actually a communication of a need to connect with another, to receive comfort in a distressing time, to feel loved, accepted, to belong to someone, or just to feel good for a little while.
It goes back to the idea that behaviour is primarily a form of communication for people with dementia, and if we seek to control someone’s behaviour rather than trying to understand what they are communicating we may miss some basic social and emotional needs that individual is trying to express. Particularly because behaviour that is viewed as sexual (whether it actually is or not) can be a concern in a communal living environment where some of the people living there may lack capacity to consent to a sexual encounter.
So how do we wade through our own ideas of sexuality and ageing, to see sexual behaviour for what it is? How do we create environments where people are accepted as human beings with needs and not viewed as dirty or predatory if they express those needs? Where does safeguarding and capacity figure into this equation? How do we talk to our colleagues and the families and carers of those we support about sexuality and behaviour in a way that is dignified, respectful, and thoughtful?
Join us at the Dementia Services Development Centre as we explore best practice approaches to dementia, sexuality and supportive living environments. Find out about our Dementia and Sexuality training.