Sexual expression in persons living with dementia

Abstract

Background: Due to disinhibition and disorientation, individuals living with dementia may express sexual desires leading to negative experiences for persons living with dementia and nurses. However, the need for sexual expression does not diminish with age or loss of capacity and continues to provide psychological and physical benefits in later life.

Aims and Objectives: The purpose of this literature review is twofold, first, to evaluate the evidence concerning sexual expression by people living with dementia, and how acute care nurses respond to this. Secondly, this review will explore how central the person with dementia is in research retrieved and how they are portrayed.

Methods: An integrative literature review using five key databases from the years 2006-2016 was undertaken. Studies were subject to inclusion/exclusion criteria and organised thematically. Nine research studies were eligible to be included in this review.

Findings: Four themes were identified: (1) the importance of sexuality in persons living with dementia; (2) nurses’ opinions and experiences regarding sexual expression in dementia; (3) management of sexual expression in long-term care settings; and (4) the perspectives of persons living with dementia and their nurses in acute care settings. Additionally, an argument for reframing sexual expression in dementia through a person-centred lens rather than through a behavioural lens will be proposed.

Discussion:The review found limited research on dementia care and sexual expression especially for the acute care context. More effective, person-centred interventions are needed for this care group. Increasing knowledge about the different ways persons living with dementia sexually express themselves will help develop more evidence based interventions. Further, research regarding persons with dementia and sexual expression has rarely included persons living with dementia themselves.

Relevance to clinical practice: Gerontological nurses are for the time being, drawing on a very limited evidence base; more person-centred research regarding dementia and sexual expression is needed.