Sexuality among elderly patients with dementia: Are we aware of their needs?

Introduction Sexuality is one of the basic needs in human life and its positive effects for the wellbeing are undeniable. People with dementia, despite cognition and functioning impairments, still pursue intimacy as part of their expression of basic human instincts. Objectives We aim to address th...

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Main Authors: L. Santa Marinha, O. Nombora, M. Basto, P. Felgueiras, A. Horta
Format: Article
Language:English
Published: Cambridge University Press 2022-06-01
Series:European Psychiatry
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S0924933822020867/type/journal_article
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author L. Santa Marinha
O. Nombora
M. Basto
P. Felgueiras
A. Horta
author_facet L. Santa Marinha
O. Nombora
M. Basto
P. Felgueiras
A. Horta
author_sort L. Santa Marinha
collection DOAJ
description Introduction Sexuality is one of the basic needs in human life and its positive effects for the wellbeing are undeniable. People with dementia, despite cognition and functioning impairments, still pursue intimacy as part of their expression of basic human instincts. Objectives We aim to address the subject of sexuality among patients with dementia, emphasizing the physiological, environmental and legal barriers. Methods We conduct a non-systematic review of recent evidence on dementia and sexuality, using PubMed/Medline database. Results People with dementia face several difficulties expressing their sexuality. First, they struggle with physiological barriers to enjoyment of sexuality, such as ageism, apathy and limited free mobility. Secondly, either at home or in long-term care facilities, privacy is usually abolished. For care facilities, the Sexuality Assessment Tool supports the normalization of sexuality and self-audit policies that promote resident rights for privacy and assistance. Moreover, expression of sexuality in elderly can be misinterpreted as disinhibition, leading to unnecessary use of psychotropics to cease these behaviors. Additionally, legal barriers regarding consent arise when a partner loses the ability to consent sexual activity, questioning agreement and mutual desire. The Lichtenberg and Strzepek Decision Tree for Capacity to Participate in Intimate Relationships can be helpful to address this issue. Conclusions Sexuality in older people remains neglected in clinical intervention. Besides the urgent need to deconstruct stereotypes, families and staff must be sensitized to understand the changes in expression and perception of sexuality among people with dementia, rather than being indifferent or medicate what can be perceived as disinhibited/distorted expressions of normal needs. Disclosure No significant relationships.
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spelling doaj.art-2e077bc5f05449e99d20ebed1c378d7b2023-11-17T05:08:56ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S806S80710.1192/j.eurpsy.2022.2086Sexuality among elderly patients with dementia: Are we aware of their needs?L. Santa Marinha0O. Nombora1M. Basto2P. Felgueiras3A. Horta4Vila Nova de Gaia Hospital Center, Psychiatry And Mental Health Service, Vila Nova de Gaia, PortugalVila Nova de Gaia Hospital Center, Psychiatry And Mental Health Service, Vila Nova de Gaia, PortugalVila Nova de Gaia Hospital Center, Psychiatry And Mental Health Service, Vila Nova de Gaia, PortugalVila Nova de Gaia Hospital Center, Psychiatry And Mental Health Service, Vila Nova de Gaia, PortugalVila Nova de Gaia Hospital Center, Psychiatry And Mental Health Service, Vila Nova de Gaia, Portugal Introduction Sexuality is one of the basic needs in human life and its positive effects for the wellbeing are undeniable. People with dementia, despite cognition and functioning impairments, still pursue intimacy as part of their expression of basic human instincts. Objectives We aim to address the subject of sexuality among patients with dementia, emphasizing the physiological, environmental and legal barriers. Methods We conduct a non-systematic review of recent evidence on dementia and sexuality, using PubMed/Medline database. Results People with dementia face several difficulties expressing their sexuality. First, they struggle with physiological barriers to enjoyment of sexuality, such as ageism, apathy and limited free mobility. Secondly, either at home or in long-term care facilities, privacy is usually abolished. For care facilities, the Sexuality Assessment Tool supports the normalization of sexuality and self-audit policies that promote resident rights for privacy and assistance. Moreover, expression of sexuality in elderly can be misinterpreted as disinhibition, leading to unnecessary use of psychotropics to cease these behaviors. Additionally, legal barriers regarding consent arise when a partner loses the ability to consent sexual activity, questioning agreement and mutual desire. The Lichtenberg and Strzepek Decision Tree for Capacity to Participate in Intimate Relationships can be helpful to address this issue. Conclusions Sexuality in older people remains neglected in clinical intervention. Besides the urgent need to deconstruct stereotypes, families and staff must be sensitized to understand the changes in expression and perception of sexuality among people with dementia, rather than being indifferent or medicate what can be perceived as disinhibited/distorted expressions of normal needs. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822020867/type/journal_articleDementiasexuality
spellingShingle L. Santa Marinha
O. Nombora
M. Basto
P. Felgueiras
A. Horta
Sexuality among elderly patients with dementia: Are we aware of their needs?
European Psychiatry
Dementia
sexuality
title Sexuality among elderly patients with dementia: Are we aware of their needs?
title_full Sexuality among elderly patients with dementia: Are we aware of their needs?
title_fullStr Sexuality among elderly patients with dementia: Are we aware of their needs?
title_full_unstemmed Sexuality among elderly patients with dementia: Are we aware of their needs?
title_short Sexuality among elderly patients with dementia: Are we aware of their needs?
title_sort sexuality among elderly patients with dementia are we aware of their needs
topic Dementia
sexuality
url https://www.cambridge.org/core/product/identifier/S0924933822020867/type/journal_article
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