An 80-year-old nurse is on a crusade to raise awareness about the sexual needs of people with dementia, and the necessity for them in some cases to use sex workers.
It is estimated 322,000 Australians have dementia, a figure that is expected to rise dramatically and become a major health issue with the nation's ageing population.
While people with dementia may lose their cognitive ability, they do not lose their sexuality, and advocates argue in some cases one way to manage an unmet sexual urge is to allow the patient to use sex workers.
Registered nurse Elaine White says she specialises in matters "below the belt" - bladder, bowel and sexuality.
Ms White says that although people may not remember what they do on a daily basis, they still speak about past intimate encounters.
She is visiting nursing homes in the Newcastle area to talk about sex.
Her campaign is about human rights and understanding that no matter how a person is, they still need intimacy.
"Sexuality is inherent in all of us. It is the thread of human existence; it is a birth-to-death continuum," she said.
"They may not know what they had for breakfast, but they can actually tell you their loving warmth encounters that they have had throughout their life."
Lyndell Cohen, the care service manager at Garden Suburb Aged Care in the NSW Hunter region, says a person does not lose their need for intimacy when they are diagnosed with dementia.
If anything, she says, the need increases.
"We don't lose the feeling, and as human beings we all need touch," Ms Cohen said.
"When somebody has been married for 65 years and they come into a facility, who are we to say that they can't hug or kiss or hold hands or share intimate times?" she said.
"I don't believe that that should stop and we would certainly make appropriate areas available to allow that to continue."
Ms Cohen has enlisted Ms White's expertise to deal with a patient.
"Heather's been disrobing of late and quite frequently throughout the day," she said.
"It is starting to cause a few issues with people visiting [and] also people who are living here.
"They get her dressed for the day, then she comes down to the main area and she strips off, right down to her underwear - losing all her inhibitions."
Ms White says recording the aged care resident's life history on admission, including their sexual history, will provide the clues needed to manage their behaviour.
She argues that where someone is missing intimacy, remedial massage can be helpful, but in some cases employing a sex worker is required.
"If they had been using the services of a surrogate partner, well then you would reengage that for them," she said.
"Some people like to look at sexually explicit DVDs or magazines. Some ladies, I always ask their sexual history, you know - did they use a sexual aid?"
Sex worker Rachel Wotton features in the documentary Scarlet Road, and hopes by speaking out she can break down the stereotypes and popular misconceptions held about people with disabilities and their sexuality.
Ms Wotton, along with fellow sex workers Saul Isbister, established the charity Touching Base, which helps people with a disability - including those with dementia - access the services of sex workers.
Ms Isbister, the president of Touching Base, says demand for their services is increasing.
"What is important is that people know they are giving informed consent, which means that they understand what sex is, they understand that they are going to visit a sex worker, that they are not meeting a new personal partner," she said.
"This is not a personal relationship - this is a professional relationship."