One key part of being human that often gets overlooked in clinical settings is our ability to feel love, intimacy, and sexuality—even when facing cognitive decline like dementia. Many people wrongly think that cognitive decline means you can’t give sexual consent. This stems from the belief that sexuality requires high cognitive functioning. But, studies show that the brain area responsible for attachment, love, and lust is actually quite basic: the Ventral Tegmental Area (VTA). This part of the brain releases dopamine, which makes us feel good when we do rewarding things. It’s also a big part of our brain’s reward system, driving us to seek companionship and form emotional bonds. Surprisingly, this doesn’t require complex thinking, which challenges the idea that high-level thinking is needed for love and intimacy.
This understanding has big implications, especially for how we view and support people with moderate to severe dementia. Traditionally, it was thought that as cognitive function declines, so does the ability to express and feel emotions. But, the role of the primitive brain area suggests otherwise. Despite cognitive impairments, people with dementia can still experience love, attachment, and a need for intimacy.
Realizing that these basic human experiences don’t disappear with declining cognitive functions changes our approach to dementia care. It calls for more empathetic, person-centered care models that recognize and support the emotional and social needs of those with dementia. Instead of just focusing on cognitive deficits and managing behavior, caregivers and family members can work to maintain and 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 view people with dementia. Recognizing that their capacity for love and intimacy remains intact can help reduce the stigma and social isolation often associated with dementia. By understanding that these individuals retain their emotional depth, we can better appreciate their full humanity, ensure they live with dignity and respect, and allow them to express their love and attachment to others.