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Sexuality and Disability

, Volume 16, Issue 3, pp 205–217 | Cite as

Inappropriate Sexual Behavior in Dementia: A Review of the Treatment Literature

  • Lance Harris
  • Monna Wier
Article

Abstract

Research concerning the treatment of sexually inappropriate behavior in individuals with dementia, and information concerning the treatment of those problems is not abundant. The reasons for this relative neglect are many, but the discomfort caregivers feel in discussing sexual difficulties and the cultural bias of ageism undoubtedly contribute. This manuscript reviews the literature concerning sexually inappropriate behavior in demented individuals. Behavioral and pharmacological treatment approaches are explored, and recommendations and guidelines offered by other researchers are described. Caregiver stress and other potentially serious results that can accrue from sexually indiscreet behavior is investigated, and cautions regarding provider inattention to this issue are voiced.

dementia sexuality treatment 

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REFERENCES

  1. 1.
    Karlen A, Moglia R: Sexuality, Aging, and the Education of Health Professionals. Sexuality and Disability, 13(3), 191–199, 1995Google Scholar
  2. 2.
    Rosen WG, Mohs RC, Davis KL: A New Rating Scale for Alzheimer's Disease. Am. J. Psychiatry, 14, 1356–1364, 1984Google Scholar
  3. 3.
    Knopman DS, Knapp MJ, Gracon SI, Davis CS: The Clinician Interview-Based Impression (CIBI): A Clinician's Global Change Rating Scale in Alzheimer's Disease. Neurology, 44, 2315–2321, 1994PubMedGoogle Scholar
  4. 4.
    Burns A, Jacoby R, Levy R: Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behavior. Brit. J. Psychiatry, 157, 86–94, 1990Google Scholar
  5. 5.
    Haddad PM, Benbow SM: Sexual Problems Associated with Dementia: Part I, Problems and Their Consequences. Int. J. Geriatric Psychiatry, 8, 547–551, 1993Google Scholar
  6. 6.
    Miller BL, Darby AL, Yener GG, Mena I: Dietary Changes, Compulsions and Sexual Behavior in Frontotemporal Degeneration. Dementia, 6, 195–199, 1995PubMedGoogle Scholar
  7. 7.
    Devanand DP, Brockington CD, Moody BJ, Brown RP, Mayeux R, Endicott J, Sackeim HA: Behavioral Syndromes in Alzheimer's Disease. Int. Psychogeriatrics 4(Suppl. 2), 161–184, 1992Google Scholar
  8. 8.
    Mayeux R, The Psychiatric and Sexual Complications of Parkinson's Disease. Special Issue: The Physician's Guide to Counseling the Elderly. Medical Aspects of Human Sexuality, 21(3), 68–72, 1987Google Scholar
  9. 9.
    Lilly R, Cummings JL, Benson D, Frankel M: The Human Kluver-Bucy Syndrome. Neurology, 33, 1141–1145, 1983PubMedGoogle Scholar
  10. 10.
    Cartier L, Ramirez P, Ferrer S: Limbic Dementia: Report of Three Cases. Revista Chilena de Neuro Psiquitria, 22(2), 147–154, 1984Google Scholar
  11. 11.
    Swearer JM, Drachman DA, O'Donnell BF: Troublesome and Disruptive Behaviors in Dementia: Relationships to Diagnosis and Disease Severity. J.Amer. Geriatr. Soc., 36, 784–790, 1988Google Scholar
  12. 12.
    Patterson MB, Schnell MA, Martin RJ, Mendez W, Smyth KA, Whitehouse PJ: Assessment of Behavioral and Affective Symptoms in Alzheimer's Disease. J. Geritr. Psychiatry Neurol., 3, 21–30, 1990Google Scholar
  13. 13.
    Teri L, Larson EB, Reifler BV: Behavioral Disturbance in Dementia of the Alzheimer's Type. Am. Geriatr. Soc., 36, 1–6, 1988Google Scholar
  14. 14.
    Teri L, Borson SB, Kiyak A, Yamagishi M: Behavioral Disturbance, Cognitive Dysfunction, and Functional Skill Prevalence and Relationship in Alzheimer's Disease. J. Am. Geriatr. Soc., 37, 109–116, 1989PubMedGoogle Scholar
  15. 15.
    Carrier L: Erotomania and Senile Dementia: Letters to the Editor: Am. J. Psychiatry, 147(8), 1092, 1990Google Scholar
  16. 16.
    Cummings JL, Victoroff JI: Noncognitive Neuropsychiatric Syndromes in Alzheimer's Disease. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 3(2), 140–158, 1990Google Scholar
  17. 17.
    Duffy LM: Sexual Behavior and Marital Intimacy in Alzheimer's Couples: A Family Theory Perspective. Sexuality and Disability, 13(3), 239–254Google Scholar
  18. 18.
    Mayers KS, Solberg C: Inappropriate Social and Sexual Responses to a Female Student by Male Patients with Dementia and Organic Brain Disorder. Sexuality and Disability, 12(3), 207–211, 1994Google Scholar
  19. 19.
    Mayers KS: Sexuality and the Patient with Dementia. Sexuality and Disability, 12(3), 213–219, 1994Google Scholar
  20. 20.
    Kumar A, Koss E, Metzler D, Moore A, Friedland RP: Brief Report; Behavioral Symptomatology in Dementia of the Alzheimer's Type. Alz. Dis. and Assoc. Disorders, 2(4), 363–365, 1988Google Scholar
  21. 21.
    Barusch AS: Problems and Coping Strategies of Elderly Spouse Caregivers. The Gerontologist, 28(5), 677–685Google Scholar
  22. 22.
    Mcgowin DS: Living in the Labyrinth: A Personal Journey through the Maze of Alzheimer's (Audiotape), Thorndike, MA, Thorndike Press, 1994 (ISBN 0-7862-9976-2)Google Scholar
  23. 23.
    Fisher LL: Behavior Management of the Dementias. Cli. Psychology Review, 10, 611–629, 1990Google Scholar
  24. 24.
    Scott VK, Personal Communication, Alzheimer's Dementia Care Unit, American Lake Div., VA Puget Sound Health Care SystemGoogle Scholar
  25. 25.
    Ballard EL: Attitudes, Myths, and Realities: Helping Family and Professional Caregivers Cope with Sexuality in the Alzheimer's Patient. Sexuality and Disability, 13(3), 255–270Google Scholar
  26. 26.
    Lichtenberg PA, Strzpek DM: Assessments of Institutionalized Dementia Patients' Competencies to Participate in Intimate Relationships. The Gerentologist, 30(1), 117–120, 1990Google Scholar
  27. 27.
    Livini MD: Nurses' Attitudes Toward Sexuality and Dementia: Measurement of the Effects of an Education Program. Am. J. Geriatr. Psychiatry, 2(4), 338–345, 1994Google Scholar
  28. 28.
    Munoz DR, Regimbal JW, Sackmann MM, Avery LA: Personal Communication, Internal Medicine Northwest, Tacoma, WA, 1997Google Scholar
  29. 29.
    Hepburn K: Special Care Problems; No. 3, Inappropriate Sexual Behavior. Department of Veterans Affairs, U.S. Govt. Printing Office, 1990Google Scholar
  30. 30.
    Brown J, Lyon PC, Sellers TD: Caring for the Family Caregivers. In Clinical Management of Alzheimer's Disease, L Volicer, KJ Fabiszewski, YL Rheaume, KE Lasch (eds). Rockville MD, Aspen Publishers, 29–41, 1988Google Scholar
  31. 31.
    Hamdy RC, Turnbill JM, Clark W, Lancaster MM: Alzheimer's Disease: A Handbook for Caregivers. Chicago, Mosby, 1994Google Scholar
  32. 32.
    O'Donnell BF, Drachman DA, Barnes HJ, Peterson KE, Swearer JM, Lew RA: Incontinence and Troublesome Behaviors Predict Institutionalization in Dementia. J. Geriatr. Psychiatry and Neurol., 5, 45–52, 1992Google Scholar
  33. 33.
    Colenda CC, Rapp SR, Leist JC, Poses RM: Clinical Variables Influencing Treatment Decisions for Agitated Dementia Patients: Survey of Physician Judgments. J. Am. Geriatr. Soc., 44, 1375–1379, 1996PubMedGoogle Scholar
  34. 34.
    Lantz MS, Marin D: Pharmacological Treatment of Agitation in Dementia: A Comprehensive Review. J. Am. Geriatr. Psychiatry and Neurol., 9, 107–119, 1996Google Scholar
  35. 35.
    Leibovici A, Tariot PN: Agitation Associated with Dementia: A Systematic Approach to Treatment. Psychopharmacol. Bull., 24, 49–53, 1988PubMedGoogle Scholar
  36. 36.
    Risse SC, Cubberly L, Lampe TH, Zimmers R, Raskin MA: Acute Effects of Neuroleptic Withdrawal in Elderly Dementia Patients. J. Geriatr, Drug Ther., 2, 65–77, 1987Google Scholar
  37. 37.
    Leo RJ, Kim KY: Clomipramine Treatment of Paraphilias in Elderly Demented Patients. J. Am. Geriatr. Psychia. Neurol., 8, 123–124, 1995Google Scholar
  38. 38.
    Zayas EM, Grossberg GT: Treating the Agitated Alzheimer's Patient. J. Clin. Psychiatry, 57(Suppl.7), 46–51, 1996Google Scholar
  39. 39.
    Nadal M, Allgulander S: Normalization of Sexual Behavior in a Female with Dementia after Treatment with Cyproterone. Int. J. Geriatr. Psychiatry, 8, 265–267, 1993Google Scholar
  40. 40.
    Ott BR: Leuprolide Treatment of Sexual Aggression in a Patient with Dementia and the Kluver-Bucy Syndrome. Clin. Neuropharmacology, 18(5), 443–447, 1995Google Scholar
  41. 41.
    Cooper AJ: Medroxyprogesterone Acetate (MPA) Treatment of Sexual Acting Out in Men Suffering From Dementia. J. Clin. Psychiatry, 48(9), 368–370, 1987PubMedGoogle Scholar

Copyright information

© Human Sciences Press, Inc. 1998

Authors and Affiliations

  • Lance Harris
    • 1
  • Monna Wier
    • 2
  1. 1.Private PracticeTacoma
  2. 2.Department of Veterans AffairsAmerican Lake Division of the Puget Sound Health Care SystemUSA

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