Alzheimer's parent in a nursing home is overly sexual. Any advice?

A wheelchair should always be put away out of sight when the person is in bed so the person isn't tempted into trying to get in it by themselves.

This must be a very difficult situation for you. Hopefully someone who has had a similar experience will respond to your post.

Since your father's had this issue for what sounds like most of his adult life he's not likely to change now. I think his being asked to leave the NH at some point is a very real concern.

Have you spoken to his Dr. about anti-anxiety meds? I don't think your father's behavior is related to anxiety but the meds may slow him down a bit. If it were my father I'd rather he be medicated than prowling the hallways looking for women to assault.

Thank you, Eyerishlass. He is already on lorazepam (generic ativan) 3X a day but it doesn't seem to do a thing to curb this behavior, maybe increase the dosage? I should ask the doctor. He is on low dosage lorazepam to slow him down since he was always getting out of his wheelchair, trying to walk around, resulting in numerous falls and tumbles and he is normally hyper-manic, talking 24/7 until he chokes on his own saliva. I SO agree, I'd rather see him medicated some more than trying to kiss on whoever, whenever. I'm also worried that a family member of one of the women will get angry, and assault my father, not that he wouldn't have it coming, but...well, you know...it wouldn't be the first time in his life that someone has kicked his butt or confronted him for sexual advances. Mother is dead, I'm the only surviving sibling, so it's all on me to handle. I'll ask the doctor about raising the dosage and also about putting wheelchair out of sight once he's ready for bed, he uses a urinal at night so no need for him to be out of his bed or his room once it's bedtime. Thank you.

You said your dad was manic? Add that to the hypersexuality and those are 2 hallmark symptoms of bipolar. Has your dad ever been treated for bipolar?

From one daughter to another I can appreciate how difficult and uncomfortable this must be for you and I'm sorry you have to go through this.

Kala, both testicular cancer and prostate hyperplasia can trigger hypersexual activity. He needs a good checkup and PSA test. Testicles are imaged via MRI. If he ever took any testosterone enhancing supplements, he is at risk.

I agree with Pam. In fact, I wonder if he could be taking Viagra?

Many men of his generation seemed to think it was perfectly acceptable to make sexual remarks to women, and to get "handsy" sometimes. It was part of proving they were real he-men, or something. I can't tell you how many old-timers I had to push off me when I started out working as a young newspaper reporter. No matter how much I told them it wasn't acceptable, they never seemed to get the message. It was something about "the Greatest Generation" that I found particularly revolting.
Definitely move his wheelchair so he can't go creeping into women's rooms at night, like the Sheik of Araby.

A friend's dad has dementia and is beyond being simply aggressively flirtatious. There is a specific type of dementia where sexuality is the main difficulty with the person, exactly as you described. My friend's dad used to be a cop,a position of authority where everyone smiled and agreed wth him while he was on duty of course. Now that he is retired, and has dementia, he thinks all the women should still be smiling to him, and flirtatious right back at him. He will never accept that he is not an alpha male anymore, per his past profession as a cop. However...if a lady were to come on to him and treat him the same way he tried to treat her, he'd run scared, so perhaps that info might help. One other thing; employees in a nursing home are trained to handle all types. Don't let them try to make you feel as though he is an exception; he is merely another personality, and still a person, and they willhave to "bother" to take care of him properly and handle this situation properly. I am a state volunteer advocate for senior citizens in nursing home settings. If I see something not being handles right, the facility gets wrote up and then state comes in to ivestigate, etc. So you hang in there, as to speak with head nurse to see how they are handling his diagnosis, and also ask who is the State Long Term Care Ombudsman for that facility. : )

I don't have the answers, just a simple, you are not alone. I have several Alz clients who express themselves this wa,y and it makes it very difficult to find the right setting or caregivers who are "well" trained & Willing to work with them. Medication works to some degree, but the side effect is, they become non-communicative. The best advise I can offer you, is to step away, take care of yourself, put you first, and leave the behaviors to the professionals to handle. The DON & Physician, should be the one helping you find the right combination of medications to subdue the behavior. Unfortunately, ALZ seems to exasperate the worst behaviors in people.

I agree with the above....leave it to the professionals. Do not accept attitudes over the phone ( as if you can control dad's behavior). Your father is not an exception. In fact sexual activity between the elderly in nursing homes is a known problem. Every facility has a patient representative who is a go between with the patient, family and facility. I suggest you get in touch with this staff member. Let him/her know how poorly the staff has treated you. Let him/her do the job they get paid for .

I feel for you but I can't believe a nursing home would kick them out, what is the family supposed to do? thats why they are in a nursing facility is because they no longer can be cared for at home. I wish you well as I don't have any answers. Its just a shame thats all.

One good thing is that you do not live with your father.

As a nursing home staff myself, I do have some advices to you. The next time when you speak with the staffs who can make decisions in the nursing home, for example social worker, head nurse etc. for the safety of your father and other residents in the nursing home, you can suggest and agree the following :

a. Agree having him on a wheelchair which he could not unbuckled his safety belt, so that he would not fall again.

b. Agree having him rest in a bed after breakfast, lunch, dinner and especially at night as often as he wishes or "as needed". When he is in bed, move his wheelchair away from his bed, having the bed rail up, ELEVATE the leg part of the bed while the head part down. In doing so, you are preventing him from the risk of fall himself, and preventing him from entering the room of other female residents. To my best knowledge, such preventive actions does not legally considered restraint, while serving good purposes to ultimately everyone that is involved, your father, other residents, the families, the nursing staffs etc.

Wish my advices to you do help and peace be with you.

I wonder if they still have salt Peter (spelling) they used to give it to horny servicemen. My father in law was in a home for a long time after a stroke. My niece was a nurse there for a while. He didn't recognize her and she walked into his room one day while he was pleasuring himself and she said " put that thing away, you're not impressing anyone with that!" Too funny on her part, but I think it happens quite often in these aging care facilities.

Feel for you, have a small bit of this with my dad, not to your extent. My dad gets a crush on every nurse/health aide that works with him for more than a week, and then wants to move in with them or have them move in with him, wants to give them cash, buy them stuff, sadly most are willing to oblige him to some extent if they think they can get something. Sad. I agree with the bipolar issue, I think your dad needs a heavier med than Ativan. Remove the wheelchair as often as possible to keep him under control better. Good luck.

There is a stigma about elderly people that they do not have any sexual desires after retirement.... Guess what? They do! It's rather normal for men (and women!) to be sexual even after age of 60+, 70+, 80+, etc..... Indeed, you did not describe anything unusual. But what I really find unusual is that the staff in the NH is so poorly trained and facility can't handle this situation properly.
Considering that your dad is sitting in the chair all the time I am wondering how he can reach up to all those cute chicks he kiss' in the mouth? They must be sitting on his laps or bend down to get that kiss. So, I see that one person is blamed for all...
Yes, he probably was affectionate man all his life and now he is expressing himself in the way he always did, just not as selective. Have mercy for old guy! He is earning for respond and wants to be loved back.
Suggestion to keep him in the bed around the clock is not humane.
Yes, he needs to be checked for cancer and sure he might be bi-polar through his life... but the NH should be able to train their staff to handle this situation and not to call you every time he had kissed somebody. They charge soooooo much, that obviously can offer little more attention to your father's needs. Nope, it's not what you think! I meant to keep him busy beyond just giving meds and changing diapers. He needs activities to keep his hands and brain busy -- fording towels, sorting papers, listening music, "holding" newspapers, watching/feeding birds, playing with cat/dog, clipping coupons, "watering" flowers pots, going for a walk outside building (community volunteer?). Do they have garden grounds there?
Yes, he needs companion!

Excellent answer, Gilliboo.

I am a former Ombudsman Supervisor, so with that in mind ...
Previous nursing facilities where your father lived will have documentation of his behavior, therefore, his present nursing home must have known about his sexual predilections before accepting him as a resident. By accepting your dad as a resident, the present facility acknowledged that they could deal with the behavior issues and have no excuse in the discharge of your father unless he is endangering another resident.
In case the facility does send a 30-day discharge notice, they must ensure he is going to a safe and healthy environment before sending him on his way, and it seems the only place to send him is home to you. Say no to this. If you do not accept him into your home, the facility cannot place him elsewhere without your (if you are Power of Attorney) permission.

Call the Ombudsman Supervisor for the facility. She works for the Aging Services Division of your state's Dept of Human Services (or whatever it's called where you live). The Ombudsman is an advocate for the residents of long term care facilities.

Suggestions: Ask the facility to assign a male CNA/nurse to your father. When a male nurse is not available, the facility should assign two female CNAs to him so they can protect each other. As for the female residents, perhaps a bell on his door (nothing too loud) might help alert the night staff that your father is up and about so they can keep a close eye on his wanderings. There should be enough staff to ensure your father receives the kind of care he needs. Although, I still think you need to talk to his doctor about his behavior.

Side note: placing a safety belt on a wheelchair is considered a restraint and against the law unless his doctor prescribes it, an authorized nurse or doctor checks on him every 30 minutes and he is released every few hours, and there is permission from your father (in his right mind) or his POA. Restraints are complicated and can be dangerous. While an Ombudsman, I found a female resident strangling when she tried to slide under the seat belt restraint to get loose.

KalaFW, you are in a difficult situation. Please let us know how things go and what was done to help you. Good luck.

PamStegMan, thank you for the suggestion. My father just had a complete physical (xrays, labs, etc) about 6 months ago, all labs normal, PSA was fine. He has been interviewed, seen by, a few psychologists. No bi-polar, but extremely off the chart narcissist egotistical person with no empathy for others due to him being so self-centered. These are not new traits, it's life long. There was never having a conversation with him, it was only listening to him and his stories and his whatevers. My mom supported his behavior for over 50 years, no one was allowed ot challenge or question him ever. This no doubt reinforced his behavior and personality.

From what you say, this is a pattern of behaviour exhibited throughout his life, so it is not a matter of his age. The major concern is that he does not force his attentions on those that do not welcome them.

Obviously, those taking care of him have to be extra-vigilant. That is their responsibility.

Your dad is not the first elderly Lothario and will not be the last. It is a problem, but it is one that can be solved or minimised by vigilant and energetic staff. Limiting his mobility is not really fair, especially an 90 years old.

Someone, a statesman, said, "Vigilance is the price of peace," or some such.

You have to admire a man his age that still gets around and is not yet done with life. Keeping a watchful eye on him to make sure his unwanted attentions do not go unchecked and do not cause problems for other clients is the responsibility of the NH.

The nursing home is in the best position to monitor his roamings without him having to be chemically sedated. Chemical interventions are more often applied to give NH staff an easier life without regard to the patient's needs.

It is not as though he were a homicidal maniac on the prowl for his next victim. Try not to let this worry you too much.

Sallie, LOL, good story (but sad, but you know it is LOL). I've seen my father and his privates far too many times, and just tell him to put it up, nobody wants to see THAT mess.

GrannySmith, I understand what you are going thru with you dad. Alas, my father doesn't develop crushes, he just feels every female is welcome and just waiting for his advances, that his smooth talking and cute little smile will put any female over the edge, putting her to her knees in front of him saying 'yes, master'. It's sickening how he pushes himself onto every single female. Now back in his younger days, he was quite a handsome man in a very isolated area in the country and I guess he could choose and pick and discard at will. But now it is just pathetic.

First, the NH should have a written policy about sex and sexuality between the patients. Because of high turnover,they should have regular staff training on how to deal with sex among patients. They should make you aware, but not make it your problem. The biggest concern I would have is that some family member raises a ruckus because your dad assaulted their mom. Put the problem back on them. Tell them to put the wheelchair away. Another tip I heard of is placing a black mat on the floor in the doorway. Some ALZheimer patients think it's a hole and won't cross over. Some NH place them in front of elevators and stairways to reduce wandering.

@KalaFW, when we become parents or caregivers to our parents we should accept that fact that we can't any more see ourselves from prospective of being "children". All rules about "normal" behavior change, sometimes into absolutely opposite direction. When we accept that fact that we have to deal with "modesty" when go to see doctors and we should be ably to overcome it, we have to understand that it's also one of conditions of being a caregiver or parent.
I never have a problem cleaning up my residents. Cleaning their private parts is the same as cleaning their face or hands. But more important, considering that those exact parts harbor more bacteria and should be kept in perfectly clean condition to prevent any serious complications.
By telling somebody to "put their private part away" while they are pleasing themselves, you are depriving them in one of normal and essential needs -- sexual satisfaction. I would never demand my residents "stop what they are doing", especially if they are doing it in their own private room with nobody else is presented. I would excuse myself to give them more time. Hopefully they are able to finish it... It might also help your dad to stay away from chasing and harassing "girls" on the floor.
Think about what else they have to be excited about while living in a NH???
When people become old, needy and depending on others, they are still human with all normal needs. We have to respect it and give them a chance to experience life as normal as possible: food+fluids+warmth+sexual satisfaction are all normal and necessary needs!

I would suggest a consultation with geriatric psychiatrist. There are many meds that could help. And this IS part of some dementias. I also agree that staff should be skilled at dealing with this behavior as it's common in these homes. Perhaps they need a special inservice planned. My Dad has been in memory care for 18 months now, and in 4 different facilities. We've seen this type of behavior from one or more people in all facilities. The current staff deal with a couple men constantly and they simply separate the two people while sternly telling the one with 'roaming hands and mouths' " You are not to act like that here' And then they make him sit in a different place and have a man sitting near him, rather than a woman. I think the bed/wheelchair arrangement suggested is a great one as it would make it much more difficult to try to get oneself out of bed alone. It is quite true that we have, in this country, regulations now against 'restraining' people, and that makes it harder to work with some behaviors. A geriatric psychiatrist should be able to prescribe medication that would block some of Dad's 'amorous' activity I think!

I would suggest asking his physician if a trial of Seroquel, an atypical anti-psychotic medication, would be appropriate. I have often seen it used to help manage difficult behaviors in patients with dementia.

Kala, so I'm reading the responses and I agree...the nursing homes deal with this all the time, and this is not abnormal behavior for many with dementia's.

Reading what you have written about your father I'll go out on a limb and say that he sounds like a psychopath ... absolutely no compassion or even an understanding of why anyone would be compassionate and very narcissistic.

My mom was a sociopath which is very similar, and very sexual throughout her life and continues to be so.

She has lived with my family for a year and half and often comes onto my husband, has crawled in bed with him while he was napping etc etc etc. Kinda creepy really...but my husband handles it well and keeps her at arms length.

She would tell me about her sexual exploits in detail, gleefully from the time I was way too young, till in my 20's I finally told her she had to stop.

She is going to be entering into a nursing home (next week now) that specializes in Dementia and this behavior is normal, even with people that did not have a history, and while it is enhanced in people that have the personality like our parents, it is not uncommon.

It seems that you understand at least in part that it is your fathers mental illness at play, but just to make sure you also understand that you are not responsible for his behavior and you absolutely should not be in a position where he is abusing you again.

Under no circumstances would I ever allow him in your home again...and yes be very clear about that and the State will find a place for him should the nursing home be totally incompetent and not be able to handle the situation appropriately.

My grandfather, who was never abusive or sexual in these ways...would say some in appropriate things when he had dementia in his later years, but with him it wasn't so bad and was absolutely the dementia.

Anyhow...try not to stress too much about it and get a hold of the people others have suggested and talk to them about it so you feel secure in case it becomes a worse problem.

Again...don't let them guilt you into taking him back...that would be a worse situation.

OH...something else I remembered. Ask the Dr to look into progesterone treatment.

It is often used for birth control, but is also used in treatment of men to lesson their desire.

So sorry you are dealing with this. This older generation thinks they are being funny when it most definetly IS NOT. It is a reason my siblings do not want to come and help me take care off him because he says things to them. It is a really tough thing to deal with. I have not had your experience with a nursing home but my anxiety rises when I know I will have to hire home care. Right Now I am in limbo between when insurance will pay (he has to be unable to bathe before I can have it paid for). Anyway I have dealt with this type of behavior for years. It has affected my family a lot. I would suggest a bed alarm to go off whenever he tries to leave his bed and nurses are alerted. Hope you get help for this and know you are not the only one, we all understand. Good luck and prayers from me to help you get through this.

Everyone seems to put this back on the nursing home staff. I totally agree that N.H. staff needs to be trained to handle sexual advances by patients. While going into a local nursing home as a hospice staff member, however, I was informed by the Dir of Nursing that the State licensing Board for their N.H. will consider patients like your father to be a sexual "predator" as it relates to other residents/patients, and thus a threat to the wellbeing of other residents. As such, the N.H. is OBLIGATED to report each incident to a family member, record that the family member had been notified, and record what was done to try and manage the behaviors. This can lead up to the ability to legally discharge someone from the N.H. Not only CAN the N.H discharge someone who is sexually acting out, especially towards other residents, they MUST discharge them... in order to protect the "rights" to a safe environment of other residents, in keeping with licensing criteria. I don't know if the same holds true for other States and their N.H.licensing criteria. (I live in Arizona)

It's extra challenging since your father has always had these types of behaviors, since dementia destroys the part of the brain that controls impulses, including sexual impulses. There's no getting that part of the brain back. And, there's no specific medication that can control these behaviors. Some may slow him down as others have mentioned. While it might not be "fair" to your father to slow him down, it's also not "fair" to other vulnerable residents to have to tolerate these behaviors. If it's medicating your father, or having lose his placement or to return home for you to have to deal with his behaviors, it might be the lesser of "evils" for ALL concerned.

As others have noted, a belt in a wheelchair is considered a "restraint" which most N.H. aren't allowed to use. (This is one where I think the "baby got thrown out with the bath water", from a time when waaay too many patients were tied down and physically restrained in nursing homes just to make it easier for staff or because there were few good medications to help calm them.) Even some medications can be considered "restraints"!!

Someone mentioned a bed alarm.....might be helpful to try Make sure they attach it to the back of the person where they're less likely to be able to reach it and take it off. Also, there are chair alarms which can be used if someone tries to stand up from their wheelchair. Again, this wouldn't help when your dad gets into a chair on his own, but could be helpful during the day when he's out and about.

Ideally there'd be enough N.H. staff to help monitor residents' behavior closely, but we all know unfortunately that this is NOT the case in most places. I, too, wonder where they expect elderly people with sexually acting out behaviors to go?????!!! Not an easy situation to have to manage, and I'm sorry you're having to deal with this, especially all on your own.!

The mention of saltpeter as a treatment sent me on a search for medications that may help. Mayo Clinic listed 5 categories of medications that may help control what they called "compulsive sexual behavior." Some of those listed seemed that they might be worth a try. Discuss these with your father's doctor and maybe they will be the answer to your problems or at least bring his Don Juan behavior down a notch.

Saltpeter won't alter his behavior, but hormonal therapy just might work. Hypersexual activity can be lessened. Anti-androgens – These drugs target the effects of androgens (a sex hormone) in males and help decrease sexual urges. They are often used to treat male pedophiles.
Your father's behavior borders on predatory and could get him booted out of the nursing home if unwelcome advances persist. I see two options here, one is castration, or removal of the over active testicles, or an Rx for estrogen therapy to quiet them down. While MD's would have no problem removing over active ovaries, they may balk at castration, for largely empathic reasons.

Just one comment about bed rails: An esteemed dementia specialist nurse practitioner advised strongly NEVER to put up bed rails! A person might try to climb over them and get stuck in the rails and die. NEVER EVER use the bed rails.

Reading your post, the first thing that I thought of is a possible mental disorder, like bi-polar disorder. Then when you said he was always hyperactive & talked a mile a minute, it clocked. Your father needs to be seen, evaluated & treated for bi-polar disorder to reduce the mania. The nursing home won't like it---they'll probably fight you--because bi-polar meds are expensive. But, if he is at risk of being kicked out for inappropriately touching the female residents, his behavior is never going to change & you'll be looking at trying to get him into another LTC facility because of his behavior.