"Lately Mom has been trying to undress at the Day Care Center. It's just started in the last two weeks. If she starts doing it when she's out with me, I don't know what I'd do."

* Even though the behavior may be upsetting or embarrassing for you, try not to overreact. The person is likely reacting to what feels good and does not remember the rules we are taught about proper social behavior. As a result, its usually best to remain calm, distract the person with another activity, or remove them from the situation.

* Respond to improper sexual advances calmly and firmly.

* Note the environmental circumstances of the behavior. Is the person removing their clothes because they are too warm? Are they touching their genitals because they need to void? Do the clothes fit incorrectly (e.g. to tight, are they chafing)?

* A counselor may help the caregiver sort out conflicting or ambiguous feelings toward the impaired person. A support group may also be able to provide suggestions and emotional support.

* If the person becomes overly aggressive, (or conversely fearful of intimacy) it may be necessary for the spouse to sleep in a separate bed or bedroom.

* Consult your physician. In some cases medication may temper sexually aggressive or violent behavior.

* Decide ahead of time how you will react if sexually inappropriate behavior would occur in public or private. Thinking things out will help you to remain calm if problems do arise.

* Protect yourself. Being a caregiver does not mean you should tolerate abusive behavior. Try to anticipate problems before they arise and seek help, as needed.

* Remember that although dementia will ultimately affect the sexual and intimate aspects of the marriage, both the impaired person and the caregiver will still have basic human desires for touch, warmth and intimacy.

(c) copyright 1996