This is the 96th instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.A quiet heartbreak is unfolding behind the closed doors of dementia care, one that few carers dare to speak about openly: the ebb of physical intimacy.A tentative question posted to an online dementia carer support group sparked a flurry of moving responses. That question: “I really don’t know how to approach this subject, but I’m wondering who is still sexually active with a partner who has a dementia diagnosis. I’m struggling with this.”It is a distressing issue for the hundreds of people who weigh in. In emotional comments, both men and women describe their experiences, challenges and concerns, such as these below:

“For the past two years, we’ve slept in separate bedrooms. I just can’t go there: there is nothing sexy about a man who never showers or shaves and does nothing all day but sleep.”

“I have so many beautiful memories, but today is a very different reality, and I can’t ‘fake’ it. I tell him my hormones don’t work any more and I can’t do it – I tell him it is all my problem – a medical one. I hug him and tell him I am sorry. So far it has worked – but it breaks my heart.”