No conversation about dementia is easy, especially when it regards someone you love. Talking about sex is no piece of cake, either. But any conversation about Alzheimer’s or dementia ought to include sex.

Because sex will very likely be an issue that caregivers have to deal with at some point. A recent patient told me that sex remains a very special connection with her husband, who is in the early stages of Alzheimer’s; she looks to preserve that connection as long as possible.

We are sexual creatures all our lives. Alzheimer’s doesn’t change that fact, although it will alter the experience and expression of sex in a relationship—both for the person with dementia and for the partner. It’s better to be emotionally prepared and to have your resources in place than to be taken by surprise by loss or uncharacteristic or embarrassing behavior.

So, let’s talk.

A diagnosis of Alzheimer’s disease is…