Dear Dr. Jenni,
I’m 78, and my wife has Alzheimer’s. It’s gotten severe over the past five years, and our sex life has fully disappeared. I feel such sadness and yearning. I can’t ask her to fulfill my sexual needs, and I’m starting to think that at 78, maybe I shouldn’t have any. I don’t know what to do because at the same time, I feel very horny (and guilty about this), and yearning for connection with another.
—Alone with Alzheimer’s
Dear Alone,
Your feelings, and needs, are very normal. Sex doesn’t stop because you entered your 70s — or 80s or 90s. As human beings, we are inherently sexual our entire lives, some of us more than others, on account of hormones, stress, illness or relationship issues.
It’s fine to feel horny. I encourage you to consider masturbation, as it can be a useful and fun outlet to access self-pleasure and explore your fantasies.
Of course, it’s also understandable that you are yearning for a connection with another, though this is undoubtedly a more difficult predicament.
Because of the severity of your wife’s Alzheimer’s, she may not be able to emotionally or physically consent to your sexual requests.
The question becomes an ethical one in which you have to ask yourself if you are comfortable seeking sex outside the marriage if your wife is unable to give full, informed consent.
You know your wife best. What do you think she might say if you had this conversation years back before any illness set in? What would she want for you now? If that question is difficult to answer, consider if the roles were reversed and you were the one with Alzheimer’s. What would you want for your wife in that scenario?
If anything, answering these questions for yourself will ultimately give you more permission to feel and explore your sexual needs, either within the confines of masturbation or with another.
Only you can make that decision.
Dear Dr. Jenni,
Every time we have sex, my husband falls asleep on me immediately after. I want to cuddle, but he’s always exhausted. I’ve told him this, and he says he wants to try, but he’s utterly exhausted. I feel at the end of my rope with this. Ideas?
—Narcoleptic Nookie
Dear Narcoleptic,
It sounds like you are feeling left out when he passes out. Many people pass out post-orgasm. Biochemically, the flood of hormones combined with the climax of arousal can certainly knock one out.
I’m curious if your husband feels exhausted in general, or does sex create exhaustion? Are you having sex only at night after a long work day? Perhaps try morning and afternoon; or be on top and take control, so that his workload is lessened. Or have sex in the shower. It’s hard to fall asleep standing up!
From a relational perspective, I wonder if you are feeling emotionally fulfilled during sex? If the answer is no, then I suggest finding ways to connect more intimately and openly during sexual activity. If you feel emotionally satiated during sex, there may be less of a need to obtain this connection post-sex.
If you already have a strong sexual/emotional connection, and he still struggles to stay awake based on biochemistry, then either cuddle before sex, cuddle as you fall asleep entwined in each other’s arms, or sanction a separate time just for cuddling and affectionate touch.
Your desire for cuddling may not ensue immediately after sex, but take matters into your own arms to ensure your needs get met sometime during the day.
Send questions for Jenni Skyler, Ph.D., to [email protected]. Skyler is a sex therapist and board-certified sexologist who runs The Intimacy Institute in Boulder, www.theintimacyinstitute.org.
 Questions Send questions for Jenni Skyler to drjenni@ theintimacyinstitute.org.
