Love makes the world go round but sex adds the sparkles: A review of “Dementia, Sex and Wellbeing”

Uruakanwa Ekwegh is a Specialty Doctor in Medicine for older people, with an interest in acute frailty and medical education. Her Twitter handle is @Kanwa10

Before I started to read this book, I asked myself, “what do you think of when you hear ‘dementia and sex’?” Two phrases leapt to my mind: “inappropriate behaviour” and “safeguarding issues”. The author acknowledges this perspective when she states that in this group of people, the issue of sex is only raised in the context of problems or concerns. She pointedly asks, “Why would we choose to ignore sex when so many adults consider it to be one of their activities of daily living?” Sex as an ADL? What a novel idea!

While reading this book, I was drawn into her conversational style of writing. She cleverly navigates the line between “stuffy” and “fluffy”. Just as I would start getting bogged down with the academic stuff, she would bring in a practical or true life example to liven things up again. And she expertly uses her words to paint the pictures of the people in her examples; you are present and witness the conversations that she references.

The content of the book as a whole is quite extensively referenced. The author has pooled insights from her multiple workshops as well as her counselling sessions over the years. There are also multiple citations from seminal publications in this area in addition to less formal sources like works of fiction and newspaper articles.

The “Points for Reflection “ at the end of each chapter doesn’t just ask you to think about what you read but also about how it made you feel. This she asks you to do, “without judgement but with mindful awareness and acceptance”. The statement was a bit too “American” for my taste but I understood what was expected of me as I read the book. I will admit, some aspects of this book didn’t sit well with me, so the reflections helped me to address why this was the case.

There were fascinating revelations for me in this book. For example, I had never considered (as she does) neurology in the same vein as age, race, culture, etc. as a potential source of discrimination. Likewise, the thought had never crossed my mind that rapists, paedophiles or their victims could develop dementia and how this may skew their view of the world that they think they live in. Most impactful, however, was the question, “why do people have sex?” The answers she explored opened my eyes to how people could be automatically denied the autonomy of their personal answer to this question just because of their diagnosis.

Having read this book I know that at least one of the author’s goals was accomplished with me: I have been able to “reflect on (my) innermost thoughts and feelings… to gain a real sense of where (my) blind spots may be”. Anyone in health and social care who works with people living with dementia (patients or carers) will benefit from her passion, experience and expert knowledge passed on in this book.

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