12. Losing inhibitions
Sometimes a person with dementia can lose their inhibitions and may behave in ways that others find embarrassing. This can include being rude, saying things that are socially inappropriate (eg commenting that someone is overweight), talking to strangers, undressing in public, and apparent sexual disinhibition (eg touching themselves inappropriately in public).
This can be embarrassing and distressing for both the person with dementia and those around them. They may not understand that what they are doing is inappropriate. It is unlikely that they are being inappropriate on purpose. When addressing the situation, it is important to uphold the person's dignity and prevent unnecessary distress.
Some common causes of losing inhibition include:
- the effects of specific types of dementia (some people with frontotemporal dementia experience a loss of inhibition because of damage to the frontal lobes in the brain)
- needing the toilet (touching themselves) or being too hot (undressing)
- boredom or wanting to talk to someone
- sexual frustration.
Embarrassing situations: tips for carers
- Try to react calmly and remember the person is not behaving in this way on purpose.
- In some situations it may help to think about whether the behaviour really matters. For example, in some situations talking to strangers may not be a problem. The person may be meeting a need to be social and the stranger may be happy to engage with them.
- Try gently distracting the person.
- Be aware of potential triggers - if you know what these are you may be able to prevent the behaviour from happening in the first place.For example, if someone behaves in a sexually inappropriate way when you help them to get changed, it may be that they are misinterpreting your actions. Try to change how you approach the situation and see if this helps.
- If the person is undressing, take them somewhere private, and check whether they are too hot or are uncomfortable, or want to use the toilet.
- If the person behaves rudely, don't attempt to argue or correct the behaviour. Try to distract their attention.
- It may help to explain to other people why the person is behaving in that way. They may be more understanding if they know why something happens and they may have some suggestions to help find solutions.
Changes in behaviour are common in dementia. However, by looking at the meaning behind the behaviour and considering what may be causing it, it is possible to find ways to support a person with dementia to live well. It is also important for carers to look after their own wellbeing and seek support for their needs. For more information see factsheet 523, Carers looking after yourself.