Hypersexuality in dementia (both the Alzheimer’s and frontotemporal types) is a common and difficult issue.
Here are five strategies for managing sexually inappropriate behavior:
1. Selective Serotonin Reuptake Inhibitors (SSRIs)
As much as people complain about how antidepressants cause a drop in libido, in the case of frontotemporal dementia, that can be a desired side effect.
2. Set Boundaries
Often times frontotemporal dementia does not affect the memory and language centers the way that Alzheimer’s disease does, at least initially. This means that it may be possible to have meaningful conversations about appropriate behavior and set boundaries that have a clear expectation of behavior. Because the ability to empathize or self-monitor the behavior might not be intact, the person with FTD may not agree with the premise. But at least the potential exists to form a contract about proper behavior.
Use another form of emotional stimulation to create a feeling of connectedness that is not related to sexual contact. Music, sentimental objects, or pleasant reminiscing may provide a rush of warm fuzzies that override more primitive urges. Food (sweets and/or crunchy foods) may also be an excellent diversion from sexual behavior, and create the satiated feeling the brain may be craving.
Sometimes sexual behavior is an expression of the desire to nurture and love someone. Sexual advances may be channeled into caring for a pet, doll, or stuffed animal. The desire to have sex may just be the desire to have a purpose (if not to procreate, then what?). Simple jobs and chores, gross motor actions, exercise, dancing… many other physical activities may be an adequate substitute.
Older adults, especially the widowed or withdrawn, may be touch-deprived and attention starved. Therefore, there is always the strong possibility that an older person who is perceived as sexually inappropriate may just be plain lonely. Irascible, irritable, and aggressive behavior of both the sexual and non-sexual variety are common traits of FTD, and frequently cause even further isolation and distance from loved ones. It is amazing what a smiling face, a listening ear, and close proximity to kind human being can do to turn that behavior around.