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Non-pharmacological management of sexual behaviours that challenge in dementia

Published online by Cambridge University Press:  03 November 2015

Hazel Thornton  and
Rosslyn Offord
Hazel Thornton
Affiliation:
University Hospital Llandough, Cardiff and Vale University Health Board, UK
Rosslyn Offord*
Affiliation:
University Hospital Llandough, Cardiff and Vale University Health Board, UK
*
Address for correspondence: Dr Rosslyn Offord, Academic Centre, University Hospital Llandough, Penarth CF64 2XX Email: [email protected]
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Summary

A literature search was conducted to identify and evaluate non-pharmacological interventions available for people living with dementia, who present with sexual behaviours that challenge. A lack of research implementing and evaluating clinical interventions was identified, and the search was broadened to include discussion papers relating to sexuality and dementia. This included work both with couples affected by dementia at home, and with staff in institutional care settings. The papers identified come from a range of countries, with wide variation in care settings and practices. Literature suggests sexual behaviours that challenge in dementia are best understood within the broader context of behavioural and psychological symptoms of dementia (BPSD). There is a consensus highlighting the importance of training staff to recognize the sexual needs of people with dementia and to develop clear policy and guidelines to support staff in managing potential challenges. Few authors attempted to include the perspectives of either care partners or the person with dementia.

Keywords

dementiasexualitybehavioural and psychological symptoms
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 25 , Issue 3 , August 2015 , pp. 194 - 201
Copyright
Copyright © Cambridge University Press 2015 

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References

1Brechin, D, Murphy, G, James, IA, Codner, J. Alternatives to antipsychotic medication: psychological approaches in managing psychological and behavioural distress in people with dementia. Leicester, British Psychological Society; 2013.Google Scholar
2Robert, P, Verhey, F, Byrne, Eet al.Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects. Consensus Paper of the European Alzheimer's Disease Consortium. European Psychiatry 2005; 20: 490–96.CrossRefGoogle Scholar
3Gauthier, S, Cummings, J, Ballard, C, Brodaty, H, Grossberg, G, Robert, P, Lyketsos, C. Management of behavioral problems in Alzheimer's disease. Int Psychogeriatrics 2010; 22: 346–72.CrossRefGoogle ScholarPubMed
4Doll, GM. Sexuality in nursing homes: practice and policy. J Gerontol Nursing 2013; 39: 30–39.CrossRefGoogle ScholarPubMed
5Tsatali, M, Tsolaki, M. Sexual function in normal elders, MCI and patients with mild dementia. Sexuality and Disability 2014; 32: 205–19.CrossRefGoogle Scholar
6Gott, M, Hinchliff, S. How important is sex in later life? The views of older people. Social Sci Med 2003; 56: 1617–28.CrossRefGoogle ScholarPubMed
7Ward, RF, Manchip, S. ‘Inappropriate’ sexual behaviours in dementia. Rev Clin Gerontol 2013; 23: 75–87.CrossRefGoogle Scholar
8Harris, L, Wier, M. Inappropriate sexual behaviours in dementia: a review of the treatment literature. Sexuality and Disability 1998; 16: 205–17.CrossRefGoogle Scholar
9Tarzia, L, Bauer, M, Fetherstonhaugh, D, Nay, R. Interviewing older people in residential aged care about sexuality: difficulties and challenges. Sexuality and Disability 2013; 31: 361–71.CrossRefGoogle Scholar
10Tsatali, MS, Tsolaki, MN, Christodoulou, TP, Papaliagkas, VT. The complex nature of inappropriate sexual behaviors in patients with dementia: can we put it into a frame? Sexuality and Disability 2011; 29: 143–56.CrossRefGoogle Scholar
11Alagiakrishnan, K, Lim, D, Brahim, Aet al.Sexually inappropriate behaviour in demented elderly people. Postgrad Med J 2005; 81: 463–66.CrossRefGoogle ScholarPubMed
12Higgins, A, Barker, P, Begley, CM. Hypersexuality and dementia: dealing with inappropriate sexual expression. Br J Nursing 2004; 13: 1330–34.CrossRefGoogle ScholarPubMed
13NICE/SCIE. Dementia: supporting people with dementia and their carers in health and social care. Clinical Guideline 42. London, National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence; 2006.Google Scholar
14Royal College of Psychiatrists, British Psychological Society and Royal College of Speech and Language Therapists. Challenging behaviour: a unified approach; 2007. Retrieved from: http://www.rcpsych.ac.uk/files/pdfversion/cr144.pdf (accessed 19 Aug 2015).Google Scholar
15Banerjee, S. The use of antipsychotic medication for people with dementia: time for action. London: Institute of Psychiatry, Kings College London; 2009.Google Scholar
16Harris, SM, Adams, MS, Zubatsky, M, White, M. A caregiver perspective of how Alzheimer's disease and related disorders affect couple intimacy. Aging Mental Health 2011; 15: 950–60.CrossRefGoogle ScholarPubMed
17Ballard, E. Attitudes, myths and realities: helping family and professional caregivers cope with sexuality in the Alzheimer's patient. Sexuality and Disability 1995; 13: 255–70.CrossRefGoogle Scholar
18Dourado, M, Finamore, C, Barroso, MF, Santos, R, Laks, J. Sexual satisfaction in dementia: perspectives of patients and spouses. Sexuality and Disability 2010; 28: 195–203.CrossRefGoogle Scholar
19Davies, HD, Zeiss, AM, Shea, EA, Tinklenberg, JR. Sexuality and intimacy in Alzheimer's patients and their partners. Sexuality and Disability 1998; 16: 193–203.CrossRefGoogle Scholar
20Loboprabhu, S, Molinari, V, Arlinghaus, K, Barr, E, Lomax, J. Spouses of patients with dementia: how do they stay together ‘Till Death Do Us Part’? J Gerontol Social Work 2005; 44: 161–74.CrossRefGoogle Scholar
21Mee Huong, L, Razali, R. Hypersexuality in dementia: a case report. ASEAN J Psychiatry 2013; 14: 170–74.Google Scholar
22Alzheimer's Society. Statistics retrieved from: http://www.alzheimers.org.uk/statistics (accessed 19 Aug 2015).Google Scholar
23Ehrenfeld, M, Bronner, G, Tabak, N, Alpert, R, Bergman, R. Sexuality among institutionalized elderly patients with dementia. Nursing Ethics 1999; 6: 144–49.CrossRefGoogle ScholarPubMed
24Di Napoli, EA, Breland, GL, Allen, RS. Staff knowledge and perceptions of sexuality and dementia of older adults in nursing homes. J Aging Health 2013; 25: 1087–105.CrossRefGoogle ScholarPubMed
25Bauer, M, McAuliffe, L, Nay, R, Chenco, C. Sexuality in older adults: effect of an education intervention on attitudes and beliefs of residential aged care staff. Educational Gerontol 2013; 39: 82–91.CrossRefGoogle Scholar
26Mayers, KS, McBride, D. Sexuality training for caretakers of geriatric residents in long term care facilities. Sexuality and Disability 1998; 16: 227–36.CrossRefGoogle Scholar
27Mahieu, L, Van Elssen, K, Gastmans, C. Nurses’ perceptions of sexuality in institutionalized elderly: a literature review. Int J Nursing Studies 2011; 48: 1140–54.CrossRefGoogle ScholarPubMed
28Villar, F, Celdran, M, Faba, J, Serrat, R. Staff attitudes towards sexual relationships among institutionalized people with dementia: does an extreme cautionary stance predominate? Int Psychogeriatrics 2014; 26: 403–12.CrossRefGoogle ScholarPubMed
29Bauer, M, Fetherstonhaugh, D, Tarzia, L, Nay, R, Beattie, E. Supporting residents’ expression of sexuality: the initial construction of a sexuality assessment tool for residential aged care facilities. BMC Geriatrics 2014; 14: 82.CrossRefGoogle ScholarPubMed
30Ehrenfeld, M, Tabak, N, Bronner, G, Bergman, R. Ethical dilemmas concerning sexuality of elderly patients suffering from dementia. Int J Nursing Practice 1997; 3: 255–59.CrossRefGoogle ScholarPubMed
31Tabak, N, Shemesh-Kigli, R. Sexuality and Alzheimer's disease: can the two go together? Nursing Forum 2006; 41: 158–66.CrossRefGoogle ScholarPubMed
32Tune, L, Rosenberg, J. Non-pharmacological treatment of inappropriate sexual behaviour in dementia: the case of the Pink Panther. Am J Geriatric Psychiatry 2008; 16: 612–13.CrossRefGoogle Scholar
33Price, E. Gay and lesbian carers: ageing in the shadow of dementia. Ageing and Society 2012; 32: 516–32.CrossRefGoogle Scholar
34Hubbard, R, Rossington, J. (1995). As we grow older: a study of the housing and support needs of older lesbian and gay Men. London, Polari Housing Association.Google Scholar
35Heaphy, B, Yip, A. Policy implications of ageing sexualities. Social and Policy Society 2006; 5: 443–51.CrossRefGoogle Scholar
36Cheston, R, Bender, M, Byatt, S. Involving people who have dementia in the evaluation of services: a review. J Mental Health 2000; 9: 471–79.CrossRefGoogle Scholar