The first time I met with Kate and John, a silver-haired and healthy-looking couple in their early 70s, I was not surprised by the story Kate told me. John, big and bearish but gentle, who had been diagnosed with dementia several months before, was a retired OB-GYN. Kate, a petite live wire, was clearly worried about him. Exhausted, she sat by her husband’s side. Both of them looked dazed and confused, angry and frightened. It only took a glance into their eyes to see that this was not where they wanted to be. Once I walked in, Kate took me aside.

“I don’t know how to say this,” she began, “so I’ll just come out with it. There’s something that happens, something that scares me, and I don’t know what to do about it. You see, I thought that our sex life was over. I was fine with that. I thought we both were. But John has become very aggressive about wanting to have sex. Honestly, I don’t know how I feel about this. Is it normal? Is his condition – or his medication – making him behave this way? Am I wrong to give in or should I resist? Please, can you help me?”

In another session, this time involving a couple in their 60s, Tom, lean and tanned, who ran a very successful business, told me about his wife Joan who had Alzheimer’s. Joan, in a designer outfit and with perfectly coiffed hair and manicured nails, gave off a glamorous air.

“She’s been a flirt all our married life, but I was never concerned. I knew it was harmless,” he told me, “but now she has become practically predatory, targeting potential sexual conquests wherever she can find them. We went to my 40th college reunion, which I thought was okay because she is mildly sedated. I couldn’t believe it; as soon as we got there, Joan was off my arm and sitting in various laps. There was no controlling her. I was beyond embarrassed. I literally had to drag her to our room and lock her in. we left early the next morning. I haven’t been able to face my old friends since. More importantly, what am I going to do? How can I help Joan – if she can be helped at all?

Neither Kate nor Tom understood, much less knew, how to cope with these unexpected sexual behaviors. They did not know that they are a normal part of dementia…

Those who read my book, Sexuality and Dementia: Compassionate and Practical Strategies for Dealing with Unexpected or Inappropriate Behaviors, will become more aware of this sometimes hidden, and yet blatantly obvious, world of sexuality and dementia. Couples reading this book may notice descriptions that remind them of elements of their own relationships. There is much you will learn of what lies hidden deep inside our partners and ourselves. I hope this will lend itself to a broader understanding and appreciations of the human condition. Armed with this new knowledge, you may even encounter situations where you can make a difference to someone.

Professionals, from caregivers to physicians, after reading this book, may make treatment and management decisions involving both dementia and non-dementia patients with a deeper understanding of our lives as human beings. The result will be a more profound quality of care.

It’s time to open the door to the hidden world of sexuality and dementia.