Rethinking relationships, intimacy and sexuality in dementia care

Traditionally, the topic of sexuality and intimacy in dementia care has focused on managing risk and responding to cognitive decline. This has often come at the cost of recognising sexuality and intimacy as essential aspects of quality of life. Intimacy, sexuality and close relationships in dementia care are frequently overlooked or treated as issues to be avoided rather than supported.

This gap has real consequences. As care moves into the home, relationships are placed under pressure. Partners and spouses often take on caregiving roles, reshaping dynamics of closeness, dependence, and identity. Power imbalances can emerge, particularly where one partner becomes increasingly reliant on the other. Questions of consent and autonomy become more complex, especially in intimate relationships, yet couples are often left without guidance on how to navigate these changes.

Many people living with dementia receive little support on how to maintain or build relationships in the future, increasing the risk of isolation. Intimacy and connection are rarely addressed as part of care planning, despite their importance for wellbeing. For people who live alone or who are single at diagnosis, challenges take a different form.

Care professionals face similar uncertainty. Without clear policies or training, staff may feel unsure about how best to respond to expressions of intimacy, particularly concerning safeguarding and consent. This can lead to overly cautious approaches that prioritise risk avoidance over person-centred care, leaving both staff and those they support without the tools to manage these situations confidently, while respecting their own boundaries and differentiating between healthy sexuality and potential abuse.

Dr Hannah Christie is a lecturer at RCSI’s School of Population Health and co-founder of the INTERDEM Special Interest Group on Relationships, Intimacy and Sexuality in Dementia, Her work examines how structural, cultural and social factors shape experiences of intimacy and relationships, and highlights how care systems can either support or restrict connection, and why a shift towards rights-based, person-centred approaches is needed.

In a recent paper published in Aging and Mental Health, Dr Christie describes the importance of dementia care and support embracing intimacy and sexuality as fundamental aspects of human life and social health. The paper argues that by shifting the focus from problems and risks to strengthening personhood and human rights, we can create environments that honor interdependence and autonomy.

This means recognising and supporting meaningful connections as a central tenet of dementia care and support at every stage. Developing such an empowering approach to intimacy and sexuality requires that researchers, practitioners, and policymakers collaborate globally and pool resources to share good practices, explore diverse perspectives (including those from marginalized groups such as cultural minorities and sexually and gender diverse individuals), and further develop evidence-based guidelines and interventions.

That’s why Dr Christie and her colleagues have set up the Special Interest Group on Relationships, Intimacy, and Sexuality, as part of the INTERDEM Taskforce on Social Health. This group works to maximise the potential of relationships, intimacy, and sexuality for strengthening dementia care and support. You can learn more about this topic at the Rethinking Intimacy and Relationships in Dementia Symposium in the Guinness Enterprise Centre on 20 May 2026.