Let’s Talk about Sex Baby!
Hey there and welcome back! Thank you for returning to read my second post. I hope that the first post gave you some information about who I am, what I do, and what you can expect to get out of this blog. It was hard to come up with a topic for my second post because I couldn’t’ decide which of the many topics I had pre-planned to debut first! So, I decided to start with one that I can guarantee is a topic on mind by all ages- SEX!
I remember one of the many times I went to my grandparents’ for dinner during college when I first realized that sex was still a topic for older adults. I was 19 years old and sitting in my grandparents’ kitchen as my Meme made her famous baked spaghetti. Meme had trouble standing/walking about the kitchen so she had an office chair she’d wheel around in while she cooked. So, she wheeled over to stir the sauce and she yelled “OUCH! I BURNED MY TITTY” (Nice choice of words, Meme.) Then my Poppy walks over and says “Do you want me to rub it for ya?” Meme says “No, let’s wait until later when Mikki leaves.” What would your reaction as a 19 year old be? You’d probably be grossed out. Cover your ears, your eyes, and run out of the house. But, that’s when I knew I was probably meant to work with older adults because my thought was “Yep! They still got it!”
Someone with dementia, who still acts on sexual impulses, may not have the ability to manage social norms. My meme didn’t have dementia, so she maintained the social norms- “Wait until Mikki leaves.” The part of the brain that regulates emotions (Amygdala) remains active throughout the entire course of dementia. So things that bring someone pleasure, like sex, will continue to bring pleasure to someone with Dementia. However, the part of the brain that regulates what is socially acceptable and not (Frontal and Temporal Lobes) or as I like to refer to it “The things your momma taught you not to say and do!” may be impaired.
Not every older adult is sexual, not every person with dementia is sexual, and not every person with dementia will have sexually inappropriate behavior. So what is sexually inappropriate behavior?
George* was a resident who was quite the ladies man. Everyone was his girlfriend. I still remember the day that I found out he had been masturbating in public, I remembered touching his hand almost every single day and hoping he had washed them after the fact. So is this behavior inappropriate? Kind of! The part that is inappropriate is not that he masturbated on a regular basis, it was that he was doing it in public. It took some investigation, but we later learned he chose the spot he did because it was a “high traffic” area where a lot of women, of all ages, walked by after lunch. We started taking George to his apartment after lunch and providing him with some visual stimulation courtesy of Hugh Heffner and his Bunnies. He stopped masturbating in public.
I had another resident, Tom* who was also very interested in sex. During training seminars, I often refer to this resident and the Certified Nurse Aide who was his primary aide. One day, she came to me and said “Mikki, Tom just asked me if I would touch his penis.” I asked her to tell me more. It turns out, this CNA, who is a very pretty young woman, went into Tom’s apartment, pulled back the covers and gently woke him up so he assumed she was there to touch his penis. At this part of the story, most of my trainees eyes get big as they try to figure out how they’d respond. “NO! You are 80 years old!” “That’s disgusting!” or just walk out and leave the man uncovered and abandoned.
I’m sure many men would respond the same way Tom did if a beautiful woman woke them up! So how did the CNA respond? She said “I can’t do that, but I can help you get ready for the day.” Tom responded by saying “OK” and then getting out of bed to get ready for the day! He was a resident we would often catch pulling his pants down in public areas and we knew it was one of two things: 1. Needing to use the bathroom 2. Wanting to masturbate. So, we would always redirect him to an appropriate place to do one or the other.
Here are some quick ways to determine whether or not a behavior is appropriate or inappropriate:
- Is it harmful to the person performing the behavior?
- Is it harmful to someone else?
- Physically
- Mentally/Psychologically/Emotionally? (This could have been true if a child walked in to see an older man masturbating).
But remember, the solution to every “inappropriate behavior” is not always medication or discharge. Shaming someone with dementia is also never the answer. It is usually most important to figure out which aspect of the behavior is actually inappropriate. In these circumstances, it was almost always the location of the behavior and we were able to provide redirection or stimulation to make the behavior more appropriate. So after you’ve determined if the behavior is inappropriate try asking yourself these questions:
- What part of the behavior is inappropriate?
- Location
- Act
- Time of day
- Who it is being done to
- It is hurting someone else?
- It is hurting the person who is doing the behavior?
- How can we change the inappropriate part, if at all?
- What method of redirection can make the behavior more appropriate?
- What we say (ie: “I can’t touch your penis but I can help you get ready for the day” vs “Ew that’s digusting!”)
- What we do (ie: guiding the person to a more appropriate location)
- What we provide (ie: Playboy!)
I want to leave you with a funny little joke from Suddenly Senior’s Joke Book.
“On hearing that her elderly grandfather had just passed away, Susan went straight to her grandparent’s house to visit her 95-year-old grandmother and comfort her. When she asked how her grandfather had died, her grandmother replied, he had a heart attack while we were making love on Sunday morning. Horrified, Susan told her grandmother that two people nearly 100 years old having sex would surely be asking for trouble. “Oh no, my dear,” replied granny. “Many years ago, realising our advanced age, we figured out the best time to do it was when the church bells would start to ring. It was just the right rhythm. Nice and slow and even. Nothing too strenuous, simply in on the Ding, and out on the Dong.” She paused, wiped away a tear and then continued, “and if that damned ice cream truck hadn’t come along, he’d still be alive today!”
*Names have been changed to protect identities.