In discussing this topic, I need to set some guidelines, so we’re all “on the same page.” Some people like sex; some don’t; some have had great sex lives for 30+ years; some have had lousy sex lives for 30+ years. Many of us had satisfying sex lives until menopause and/or medications and age changed the picture. For the purpose of this discussion, we are talking about:

THE SITUATION BEFORE ALZHEIMER’S DISEASE:

• Couples who enjoyed a mutually satisfying sex life.
• Couples who had a good attitude and were able to adjust their sex lives to their aging bodies and medications.
• Couples for whom emotional satisfaction and sexual satisfaction were tied together.

 So we get the picture – we’re talking about a positive situation before Alzheimer’s Disease.

Based upon the messages and e-mails I have been reading, it seems that many of us are in the Baby Boom Generation – remember us? The teens of the 60’s who thought we invented sex. We didn’t invent it – we just brought it out of the closet. We enjoyed it, and weren’t afraid to admit it. I’m willing to bet some of our “over 65” readers enjoyed it a whole lot, too, but didn’t discuss it in public.  

So what happens when the love of your life, the person with whom you have been enjoying sex for 30+ years, changes into someone you don’t recognize?  The dynamics of your relationship with your lover, your partner, your spouse, has changed from:

• Lover/partner to Parent/child
• Emotional supporter to a dependent, needy child
• The spouse you adored to the stranger you have confused feelings about

 Best guess is that you don’t feel like having sex with this person. One of our readers, Emily, expressed it eloquently…..” have had so much time to think about what makes a relationship. A mutually good one is like a positive feedback loop--you enjoy it, you're nourished by it, and that gives you the fuel and initiative to stoke your side of the fire. It is the ability to communicate on an intimate level that makes us desire the physical closeness. So when your partner no longer can feed your spirit, and meet your need for emotional intimacy...the desire goes away.”

In The 36-Hour Day, by Nancy L. Mace.M.A. and Peter V. Rabins, M.D. M.P.H. , they state, “The spouse of a brain-impaired person may find it impossible to enjoy a sexual relationship when so many other aspects of the relationship have changed so drastically. For many people their sexual relationship can only be good when the whole relationship is good. You may be unable to make love with a person with whom you can no longer enjoy sharing conversation, for example. It may not seem “right” to enjoy sex with a person who has changed so much."

But your partner’s brain isn’t able to think in such complex terms as you. He/she wants sex.  Period. What do you do? There are precious few resources on this subject. I just finished a clinical nursing study on marriage and Alzheimer’s – it was written 14 years ago, and said pretty much nothing, except that Alzheimer’s causes marital strife, and the changing relationship leads to uneven sexual desires. It recommended that Alzheimer Support Groups start spousal caregiver groups separate from those for caregivers of parents. 14 years ago! Not much has been done in that area in all the intervening years.

So back to – what do you do when he/she wants sex, and you don’t feel the emotional connection needed for the desire?  The 36-Hour Day  said there are no easy answers (No kidding!). Recommendations from our website members are:

• Try stroking and cuddling instead of sex.
• Participate in the sexual relations because it is something positive you can do for your spouse.
• Sleep in separate rooms. 

If you were expecting definitive answers to this difficult situation, I am sorry to disappoint you. We all have to find what works best for us. My hope is that the open, honest discussion of a previously “unspoken” topic, will at least let us all breathe a sigh of relief that we are not alone in these struggles.

Tomorrow: You want sex; your Alzheimer afflicted spouse does not.

Feedback to joang@thealzheimerspouse.com