LettersNonpharmacological Treatment of Inappropriate Sexual Behavior in Dementia: The Case of the Pink Panther
Section snippets
Editor
Sexually inappropriate behavior, often considered a type of agitated behavior, is reported to occur in 7%–25% of patients with Alzheimer disease or dementia. One of the many difficulties in treating the behavior is that it is poorly understood and poorly defined.1 Staff and physicians often prefer to treat problematic behavior using medication due to the ease of administration and perceived efficiency.2 Geriatric psychiatrists use a wide variety of pharmacological treatments including hormonal
CASE
Assisted living staff brought a 68-year-old white man to the Wesley Woods Hospital in March of 2005. He had a 4-year history of progressive dementia whose etiology could not be decided between Alzheimer disease or frontotemporal dementia. The patient had prolonged periods of agitation, including touching and grabbing the genitalia of female residents and staff, over the past year. Prior attempts to address the agitated behaviors included isolating him from females and use of antipsychotic
DISCUSSION
Although simple, single-case design studies, with the person as his or her own control, do not create substantial statistical evidence, empirical approaches rather than a standard approach to care may be the best clinical solution for patients and those around them. The nonpharmacological interventions do not always stop the behavior, but they prevent any harm from being done to the patient or those around him. Dementia has been called a heterogeneous disease: “When you have seen one case, you
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Ageing and sexuality
2016, European Geriatric MedicineCitation Excerpt :In some cases, creativity may be successful avoiding the need of medications. A case report described how a patient who was sexually aggressive toward women stopped his ISB after the introduction of a 3-foot-tall doll, as an alternative to his sexual impulsiveness [60]. If available, a consultation with a geriatric multidisciplinary team may be necessary in non-responsive patients.
Neuropsychiatric symptoms in alzheime disease and related disorders: Why do treatments work in clinical practice but not in the randomized trials?
2008, American Journal of Geriatric PsychiatryPharmacological and nonpharmacological approaches to reduce disinhibited behaviors in dementia: a systematic review
2022, International PsychogeriatricsNon-pharmacological management of sexual behaviours that challenge in dementia
2015, Reviews in Clinical Gerontology'Inappropriate' sexual behaviours in dementia
2013, Reviews in Clinical GerontologyInappropriate sexual behavior in a geriatric population
2011, International Psychogeriatrics
The authors thank collaborator Carolyn Hahn-Swanson, R.N., M.P.H. and the unit nurses who provided insight into this case as well as the patient featured and his caretakers.