Changes in Relationships

Alzheimer's may affect your relationships. While your abilities may change over time, your ability to live well with Alzheimer's depends on how you choose to continue to be a partner in your relationships.

• How Alzheimer's affects relationships
• Role changes
• How to keep your relationships positive
• Intimacy and sexuality

How Alzheimer's affects relationships

It is crucial to remember that you are still the same person you were before the diagnosis. However, after sharing your diagnosis, you may find that others are uncertain about how to respond. Some individuals may shy away, while others may be eager to stand by you and provide support. You may find that people with whom you once had a close relationship are now uncomfortable talking to you or asking you about how you are coping.

It can hurt to realize that certain family and friends you thought would be there for you can't meet your expectations now. They may have discomfort about your diagnosis, as it stirs up fears about their own futures. People who can't be a part of your support circle now may join later once they have had time to adjust to your diagnosis. You may find it difficult to participate in social activities or interactions that were once enjoyable for you. Anxiety, frustration or loss are common emotions that you may experience about changes in your ability to follow a conversation, stay focused with competing background noise, or have enough energy to participate in social activities.

For many, these changes in relationships can lead to isolation, withdrawal and depression, which can have a negative impact on your physical and emotional well-being. However, it is important to establish and maintain meaningful relationships throughout your experience with Alzheimer's as it can enhance your ability to stay both physically and emotionally healthy. Learn how others are coping with Alzheimer's and changing relationships by joining our ALZConnected message boards and reading our Tips for Daily Life page.

Role changes

As your abilities change, there will be changes in your roles and responsibilities with family and friends. As a result, you may feel:

• Excluded from conversations about long-term planning and other important decisions. Family members may have conversations or make plans for the future without your presence or feedback.
• Loss of independence or specific functions that were your primary responsibility. Those close to you may feel the need to make the decision for you about when to stop driving. You may experience a loss of employment or a loss of your role as a bread-winner. Or, others may feel that you should no longer make financial decisions.
• Fear of burdening others with a caregiving role or other responsibilities that you once managed.
• Becoming more dependent on spouse, family or friends.

All of these issues and feelings can affect your relationships. You may find that those closest to you have good intentions, but may provide help that feels invasive or unnecessary at times.

It can be difficult to do, but adapting to changes and accepting help from others can be a way to acknowledge the value their assistance brings to your life. The more you can be involved, the fewer negative feelings you may have.

How to keep your relationships positive and productive

• Be open about your feelings. Share your experience living with the disease.
• Be specific about how you would like to continue relationships and how you would like to be treated. Let others know what social activities you feel most comfortable doing and the best ways to share time together.
• Learn how to ask for help. Tell others how they can help and your expectations for support.
• Strengthen trusting relationships. Focus on those relationships which are supportive, and show your gratitude for the people you love and appreciate.
• Reevaluate relationships. Don't dwell on people unable to support you at this time or are unable to have a positive presence in your life. Give them the time to adjust to your diagnosis. Try not to take their pulling away personally.
• See yourself as unique and human. You have much left to experience.

Intimacy and sexuality

Throughout your life, your need for physical and emotional closeness and your sexuality and how you experience it, undergo changes. Some of these changes come with maturation, while others reflect changes in life circumstances, such as a diagnosis of Alzheimer's. The disease may affect sexual feelings and behavior. Take your needs and expectations for intimacy into consideration as the disease progresses.

If you have a sexual partner, openness about sexual changes is a key part of maintaining closeness. The more open and honest you can be with each other, the more you can avoid assigning blame, feeling guilty or lowering the self-esteem of either partner. It is important to educate yourself and your partner about the changes that occur and how to respond appropriately.

Your interest and expression of intimacy and sexuality may be affected by Alzheimer's in the following ways:

• Changes in roles and responsibilities: You may experience uncertainty, frustration or reduced confidence because you need help with things you once managed on your own. These emotions may lead to stress and changes in feelings toward your partner. Your partner may experience some of these same feelings and may need to make adjustments if there is uncertainty about your comfort level with sexual contact or activities that were once pleasurable for you.
• Medical issues: Depression can lead to a loss of interest in sex. Speak to your doctor if you or others have expressed concern about your emotional health. Some medications may have side effects that alter your sexual desire. As the disease progresses, you may experience significant increases or decreases in your sexual behavior. Speak with your doctor if these changes are problematic for you or a partner.

Tips for coping with changes in intimacy and sexuality:

• Accept that changes in your intimate and sexual relationships will occur over time.
• You may want to explore new ways to express sexuality and obtain satisfaction. This may include non-sexual touching or sharing memories about intimate moments.
• Communicate with your partner. Discuss new ways to connect and express closeness in ways that are mutually enjoyable.
• See more tips: Changes in Sexuality and Intimacy (PDF)

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