Understanding and managing inappropriate sexual behaviour in individuals with dementia

Inappropriate sexual behaviour (ISB) is a recognised but underdiscussed aspect of the behavioural and psychological symptoms of dementia (BPSD), and may arise from neurocognitive changes, unmet emotional or relational needs and/or environmental stressors. ISB can have significant negative effects on the individual, their family caregivers, healthcare professionals and other formal carers, and presents management challenges. Nurses have a central role in assessing and managing ISB, therefore it is essential that they understand the underlying causes of such behaviours and are able to respond compassionately and professionally. This article provides an overview of ISB, including the potential underlying causes and effects of the behaviours, and describes the elements of a comprehensive assessment and some evidence-based management strategies. The author also considers some of the ethical, legal and safeguarding aspects of sexual expression in individuals with dementia, including those displaying ISB. Adopting a person-centred approach to the assessment and management of ISB can support nurses to protect both the individual's dignity and the safety of others.