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Alzheimer’s disease and other neurocognitive disorders
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Sexuality and cognitive impairments

Throughout the various stages of a couple’s life, we may be faced with challenges regarding sexuality. In this article, various issues related to sexuality when one of the partners has cognitive impairments will be discussed, as will a recommendation.

For a caregiver, combining the cognitive impairments of their partner with the maintenance of sexual activity is a delicate subject. Desire and intimacy are natural needs that it is important to articulate.


Impact of cognitive impairments

The issue of a couple's sexuality when one of the partners has cognitive impairments is an important matter. Maintaining a couple’s intimacy may be a central issue for many people. However, some may consider the subject taboo on two fronts: active sexuality among seniors and sexuality in the context of cognitive impairments.

However, sexual desires, i.e., an urge for sexual contact, do not disappear simply because we grow old or have cognitive impairments. In contrast, when cognitive impairments start, sexual desires might increase. However, the behaviours that meet these desires may change. Beyond the changes normally related to ageing, it is important to be aware that cognitive impairments may alter sexuality. In women, cognitive impairments could lead to sexual dysfunctions mostly due to emotional or behavioural disorders. In men, sexual dysfunctions are often related to erectile difficulties. The two partners in the couple may also be confronted with many other difficulties that could be completely normal.

 

Maintaining sexuality or not

Having cognitive impairments does not mean ceasing sexual activities. If you have maintained an active sexual life with your loved one up to this point, the presence of sexual relations clearly meets your needs and also those of your partner. So why suddenly deprive both parties of something that was meeting a need? Maintaining an active sex life between two partners, despite the presence of cognitive impairments is not prohibited. However, adaptations may be necessary.

 

Solutions

If sexuality remains important for an individual, the fulfilment of this sphere is essential for personal growth and good self-esteem. One recommendation would be to have an open conversation on the subject with your partner. Starting a discussion on sexuality with a partner, whether they have cognitive impairments or not, is no simple task, especially if the topic has not been addressed much in the past. If you want to go more in-depth, various specialists (psychologists, sex therapists, marriage counsellors) can help empower you based on your needs.  You have clearly been able to adapt in the past, so why wouldn’t you be able to do so now?

Remember that there are many ways to soothe sexual desires: touch, caresses, kisses. You must never lose sight of the concept of consent. Autonomy and respect of the person, especially in the context of cognitive impairment, is important.

The counsellors at Caregiver Support can lend you a sympathetic ear, support and give you referrals. If you feel you need someone to listen to you or if you want to talk about the problem, we are here for you. You can reach us at 1-855-852-7784, or by email at [email protected]


Sources

  • Centre de santé sexuelle. Le désir sexuel et le sentiment amoureux[in French].
  • Giami, Alain, et Lorraine Ory. « Constructions sociales et professionnelles de la sexualité dans le contexte de la maladie d'alzheimer », Gérontologie et société, vol. 35 / 140, no. 1, 2012, pp. 145-158. [in French].
  • Alzheimer Society of Canada. Intimacy and Sexuality. 2018.