Dementia and Sexual Disinhibition

On a newsgroup, someone asked:

I’m a student nurse from N E England, and I’m interested in finding out about other nurses experience of managing sexual disinhibition in patients suffering from an organic brain disorder (specifically dementia/Alzheimers etc). I am currently doing an essay about an incident in which a patient would often expose himself and masturbate in communal areas, causing distress to other patients and families etc. The consultant suggested a ‘behavioural’ approach to treatment, (rather than using medication), involving re-directing the patient to his room (with the help of magazines) to ‘relieve himself’ in private. Fortunately, this plan of action was dismissed due to the legal/ethical/moral implications, and because the patients family objected (not surprisingly).

How do people feel about this?

Misreading the original post, someone remarked amongst others…

> I believe your consultant is *way* off the mark.  I have seen sexual acting-out behaviours in people who have mental retardation, and they are almost always related to anxiety or boredom.

To which, I wrote: 

Whoah, hang on a sec here!

Any sexual “acting out” has to be related to anxiety or boredom?  Maybe it’s related to a lack of a shag?  Funny thing about people in long-stay care institutions is that they are supposed to be non-sexual.

There is a huge difference between paraphilia and organic brain disinhibition.  From what is described, I doubt this is a paraphilia.

Whilst masturbating in communal areas is not exactly the polite thing to do – having a patient who masturbates shouldn’t exactly cause one to invoke a deep or inner reason or meaning for such an activity.  Nor should we take a professional stance that just because we as health care providers are aware that one of our charges likes to masturbate, that we *should* do something about it, or that there is a policy/rule-book somewhere for it.

The bloke masturbates – most blokes do masturbate, believe it or not, a lot of women do too.

Now, whilst discussing masturbation in polite company will often tend to induce a blush or two, a wank is just a wank.  I`m amazed that anyone even thought to discuss it with the family.  I`ve certainly never discussed my own masturbatory preferences with my family or anyone else’s family for that matter!

Ethical/legal considerations for giving a guy a jazz mag?  Oh come on – get the guy a few copies of loaded and FHM magazine, that`ll do it.  (Oh, one of the biggest problems about being in a total institution of any kind is to find the privacy to perform the natural and private functions of living. I`ve often wondered if those guys on Big Brother must wonder just where they could go to do what comes naturally without it being broadcast live to the masses.  A tad embarrassing doncha think?)

Best to be careful to not let something like this become the entire focus of the man’s care and day to day living needs.  I mean he`s been doing it all his life, it`s just the context that’s changed recently for him.