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He's not masturbating but he stiffens his back and panting heavily. he has Alzheimer's is takes his meds daily, could he possibly have an infection or is this normal behavior? He doesn't speak improperly to myself or others and caretaker hasn't said anything about his behavior.

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Your sisters belief that most men with dementia/Alzheimers disease are "dirty minded" is incorrect. Please encourage her to read up on human sexuality especially in the aged and demented. Has your Dad when you've asked him what's going on been able to tell you? I'm with GardenArtist. This certainly sounds like it could be a back spasm and I'd rule that out before believing that he's having
"mind only" sex, especially since he is not masturbating nor is he inappropriate in speech with either you or others.
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Addressing only the back arching and heavy breathing, my first thought would be some kind of painful spasm, perhaps from one or more of the nerves in the back. Does he have any spinal issues? Kidney problems?

Why would you think he's having mental sex?
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Stiffening of back and panting may be a side effect of medications. Has he started anything new lately? Specifically, anti-psychotics can cause tardive dyskenesia (not jusf lip smacking or tongue movements/but side and back spasms). There are other side effects but I cannot remember the names of the back arching.
This is nothing to be messed with, see the doctor right away. Never attempt to abruptly stop a psychiatric medication, or withdraw from the drug without a doctor's supervision.
This may become a life threatening symptom.
Sorry, please don't shoot the messenger. You were right to ask the question.
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Could be a seizure.
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My sister works in home care and suggested that could be the issue. He says most men w/dementia/Alzheimer are dirty minded.
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Ask the caregiver what she has seen in your father.
Just trying to cover all the bases here, and apologize in advance for mentioning this: Could it be a sign of withdrawal from a medication? Some caregivers steal the meds.
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actually my grandmother sees this guy that no one else sees and yes she has sex with him often so i know just what you are talking about and there is lots of loud gasping and sighing.
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