Couples confronted with a diagnosis of dementia face many relational changes, including changes in their intimate and sexual lives. Dementia often requires a renegotiation of the roles between partners and creativity to find new ways to keep their sexuality alive. Although family members and healthcare providers are often concerned about (inappropriate and risky) sexual behaviour of persons with dementia, patients (and partners) may experience sexuality as a human need rather than a problem. This chapter covers the impact of dementia on partner relationships from a patient’s and partner’s perspective and describes different stages of change in their sexual relation during both the phase of home care as well as after admission to a residential care facility. After focussing on (the management of) inappropriate sexual behaviour from the perspective of the family and healthcare system, the chapter elaborates on ethical issues including sexual consent, capacity, privacy and sexual rights. The chapter ends with a plea for a better understanding of the relational and sexual consequences of dementia that enables to provide tailored care to persons with dementia, their partners and their broader network.