Midwest Mary

Following is an excerpt on intimacy with Alzheimer’s disease from the book, The Alzheimer’s Spouse. You may be interested in reading more from that book or Navigating Alzheimer’s and Inspired Caregiving.

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By mid-to late Alzheimer’s, we must manage most of our spouses’ daily needs—bathing, dressing, and feeding them. Most likely, though, sexual intimacy is part of our past. Our roles have changed, and naturally so have our feelings. We are a caregiver and they are the care receiver.

Yes, we are spouses. We’re still married. But we aren’t partners. We don’t share decisions and responsibilities. Because of this, it isn’t unusual for our feelings to change. The caregiving role has altered our passions. Alzheimer’s changed us both, and therefore, our relationship.

Alzheimer’s sufferers’ sexual drive and physical ability to perform can be adversely affected by the disease and any number of medications they may be taking. Failed attempts at sexual intimacy can frustrate both spouses.

And if one spouse does not recognize the other as such, either or both may even believe intimacy is inappropriate. Advances may frighten them. It’s not uncommon for a wife of many decades to object to her husband seeing her undressed or to sleeping in her bed. She may not remember that they are married, and often doesn’t remember her husband at all.

Other couples continue to sleep in the same bed and cuddle. For them, the physical contact is comforting. And in a world where our spouse can be frightened in their own home, they may feel safer close to us at night. Still, sexual advances may not be of interest to either party.

There are no rules in the Alzheimer’s marriage. How physically close we get is a personal choice. Whatever is most comfortable for both spouses is best for the couple.

As with all areas of our marriage, things change as our spouses progress through the later stages of Alzheimer’s. What works today may not work tomorrow. Some loved ones may remain affectionate for some time, while others progressively become less so. Our Alzheimer’s spouses’ behavior can change, often within a few hours, and so will their preferences regarding intimacy. There isn’t any perfect way to predict how any of this will go . . .

Finding a new normal under difficult situations is what makes each couple unique. We may no longer enjoy the passionate love of newlyweds, but our relationship can be beautiful and tender in its own way.

What we can do.

• Enjoy the new intimacy of holding hands and snuggling on the couch.
• Sleep in another room if your spouse is uncomfortable with you in their bed.
• Remember that it is Alzheimer’s that has interfered with your sex life, not your spouse.

©Mary K. Doyle, 2025