A fundamental aspect of human experience that often goes unrecognized in clinical settings is the capacity for love, intimacy, and sexuality, even in the face of cognitive decline such as that seen in dementia. It is a common misconception that cognitive decline equals the inability to consent. This is usually related to the idea that sexuality requires a high level of cognitive functioning. However, research shows that the part of the brain responsible for attachment, love, and lust is a rather rudimentary brain area. This primitive part of the brain is crucial for releasing dopamine, a neurotransmitter that makes us feel good when we engage in rewarding activities. More importantly, the mentioned brain area is integral to our brain’s reward system, encouraging behaviors that connect us to others, such as seeking companionship and forming emotional bonds. This area does not require complex cognitive processes to operate effectively, challenging previously held beliefs that higher-level thinking is necessary for experiencing love and intimacy.
This insight has profound implications, particularly for how we view and support individuals with moderate to severe dementia. Traditionally, it was assumed that as cognitive function deteriorates, so does the capacity for emotional expression and connection. However, the involvement of the primitive brain area in these processes suggests otherwise. Despite their cognitive impairments, individuals with dementia can still experience feelings of love and attachment and express their sexuality.
Understanding that these fundamental human experiences do not vanish with the decline in higher cognitive functions changes how we should approach dementia care. It calls for a shift towards more empathetic, person-centered care models that recognize and support the emotional and social needs of those with dementia. Instead of focusing solely on the cognitive deficits and managing behavioral symptoms, caregivers and family members can work to maintain and even enhance emotional connections through various interactions and activities that stimulate these primitive brain functions.
Moreover, this knowledge encourages a broader societal shift in how we perceive people with dementia. Recognizing that the capacity for love and intimacy remains intact can help reduce the stigma and social isolation often associated with dementia. By promoting an understanding that these individuals retain their emotional depth, we can better appreciate their full humanity and ensure they live with dignity and respect.