I am finding that couples with more or less equal degrees of dementia are frequently getting together and having sex. This is not exactly happening in singles clubs but rather in long term care facilities where the rights and interests in quality of life are seriously protected.

Such relationships often begin as a casual interest and then grow into something more. A savvy caregiving staff will quickly identify the interest and begin to monitor the behavior at times trying to redirect them away from one another. This is done in the service of erring on the side of conservation to protect the patients emotionally. In some cases however, the relationship will continue to intensify – sometimes to the point where it is clear that they want to have sex.

If it is determined that there is no abuse occurring and the couple is of nearly equal levels of confusion, a meeting is often called which will include the families, physicians and facility administration. This group will then decide the fate of the relationship which at that point has usually become a choice for the family - understand that "the family" may consist of a spouse of one of the patients in question.

In the end, if all are in agreement that this is something which should be allowed to progress, the couple will be provided a place to be intimate in a secured setting. A notable and recent case involving such a decision involved the retired Supreme Court Justice Sandra Day O’Connor who made what may have been one of the most memorable decisions of her life, to allow her husband to have sex with another partner.

Douglas Wornell is the author of Sexuality and Dementia:Compassionate and Practical Strategies for Dealing with Unexpected or Inappropriate Behaviors. Check out his book for more tips and advice on living with or taking care of a person with dementia.