Loss of inhibitions and dementia

What do we mean by loss of inhibition?

Sometimes a person with dementia can lose their inhibitions and may behave in ways that others find embarrassing. This can include:

• being rude
• saying things that aren’t appropriate (for example, that someone is overweight)
• talking to strangers
• undressing in public
• apparent loss of sexual inhibition (for example, touching themselves inappropriately in public).

These situations can be very confusing, distressing, shocking or frustrating for someone with dementia, as well as for those close to them.

Why might a person with dementia lose inhibitions?

The person with dementia may not understand why their behaviour is considered inappropriate. It’s very unlikely that they are being inappropriate on purpose. They may:

• feel they are just expressing a need for affection
• be misinterpreting other people’s behaviour and think that they are reacting appropriately
• have mistaken someone for their current or previous partner and be behaving as they normally would towards them.

Loss of inhibitions is more common in certain types of dementia, such as frontotemporal dementia (FTD) which causes damage to the frontal lobes in the brain.

How to manage embarrassing or challenging situations - tips for carers

If the person behaves in a way which could be seen as sexual in public, you may feel embarrassed or upset.

You might feel that you want to protect them from other peoples’ responses to the behaviour – for example, if people are laughing or are shocked. It can help to quietly explain to others why the person with dementia is behaving in that way, for example, you could show a helpcard which explains the person’s diagnosis.

It can help to realise that behaviour that appears sexual doesn’t always indicate sexual desire. Instead, the person might be feeling or trying to indicate something different. If you can understand why someone is behaving in a certain way, it might be easy to understand their behaviour. For example:

• Someone who begins taking their clothes off in public may be too hot and trying to cool down. Or they might be uncomfortable – for example, if their clothes are itchy or tight – and be trying to undress, while not realising that this isn’t appropriate in a public place.
• Someone might also touch their genitals because they need to use the toilet.
• They may be agitated or bored.

Always respect the person and their dignity, and try not to cause them any distress.