Alzheimer's: uncomfortable situations

Summoning the courage to ask a doctor (or anyone else for that natter) discomforting questions about Alzheimer's patients' sexual activity is a universal problem. Caregivers must understand that the patient's conduct could be a fallout of the disease.

Disinhibition is a term in psychology meaning "a lack of restraint including a disregard for social conventions." In other words, those suffering from cognitive impairment such as Alzheimer's, or other forms of dementia, may be shortcoming in areas of normal, social restraint.

For instance, they may begin to form a habit of disrobing in public or in front of anybody at home, including children. This may become an extremely embarrassing situation and is, of course, inappropriate behavior.

Try to discover what could be causing your loved ones' poor deportment by analyzing the situation. Could something else be initiating this conduct? In many cases there may be something environmental triggering it.

Your loved one may suddenly begin undressing simply because they are not comfortable. They could be too hot or their clothes may be causing them to itch. Fortunately you have the option of buying clothes designed specifically for Alzheimer's patients. Simply go online and Google the words, "Alzheimer's clothing" and such items will pop-up.

One such item is a jumpsuit particularly fabricated with anti-disrobing features, including long zippers down the back complete with a dome closure behind the neck so the wearer can't get to the zipper head.

But be aware that this change will now bring on the need of extra assistance in undressing for bathroom use, etc.

I found that the looser the clothes, the better my father accepted them. He absolutely refused to wear anything that even resembled a taut fit. I couldn't even persuade him to wear socks for the last two years of his life. It was a good thing we lived in a usually warm Florida climate.

If you should find yourselves in a public place and your patient should begin to disrobe, try not to panic. First try redirection.

Attempt to turn their thoughts onto anything else besides their clothing. Also, get yourself into the habit of bringing along extra clothing. Simply having them put on a fresh shirt may solve the problem.

As I have stated in earlier writings, redirection works best when you can actually hand them something they can touch, taste or smell. For example, if you're in a restaurant, try handing them a couple of pieces of silverware and ask them which one they like better or have them taste something and ask their gourmet opinion of the flavor.

At all cost avoid becoming angry or embarrassing them. Remain composed, maybe finding somewhere private for them to sit quietly for awhile. A crowd or unfamiliar faces could be the culprit, causing them to have a bout of anxiety.

Another example of inappropriate behavior you may encounter is obscene language. Even someone who rarely swore in public before may now be throwing out words that could make a trucker blush. If they become foul mouthed or verbally abusive you may have to sit down and explain to adults and children alike who are in hearing range that it is the disease causing this poor behavior and that normally your loved one has always refrained from this kind of demeanor.

As far as dealing one on one, gently remind them that this behavior is unfitting.

If you're in a public place and you cannot divert their attention onto something else, it may be better to excuse yourselves and head back home where they will once again feel safe and secure.

Disheartening changes in people with Alzheimer's will most likely bring about unwelcome sexual behaviors. Patients may also experience an increase or decrease in their sex drive.

When the caregiver is the spouse, the patient may display rages of jealousy and might break into verbal or physical combativeness from not recognizing his or her partner. Sexual advances toward strangers usually occur due to the belief that a stranger is their companion.

A lack of attention-span on the part of the patient might leave the partner without dementia disappointed or feeling unsatisfied during and after the union of sex. Such problems usually occur during the early to moderate stages of the disease. Sexual intercourse later becomes improbable due to the patient's general decline in physical stamina.

Sexual activity is a significant way for couples to maintain their love and affection. Having this taken away can be devastating.

There are still many people who have a hard time accepting that senior citizens can be sexually active. But sympathy plays a pronounced role — bringing them emotionally closer, enhancing a sense of commitment.

The crumbling memory of an Alzheimer's patient can rip the heart of a caregiver right out. Thus, it becomes hard for one to maintain an interest in sex after caring for a loved one suffering from dementia all day. When a caregiver is mentally and physically exhausted, usually the thought of sex just flies right out the window.