Should You Cheat if Your Spouse Is in Decline?

What to know about this moral dilemma.

By
Published March 05, 2026
Illustration showing two adults holding hands in the foreground while an older adult sits in a wheelchair facing a wall of family portraits
Lily Qian

Have you stepped out on your spouse?

It’s a shocking question. The reality: a lot of folks cheat. Women in their 60s report the highest female infidelity rate (16%) according to a University of Chicago survey. Men ages 80+ commit infidelity most frequently (around 24-26%), far exceeding women in that age group (roughly 9.5%).

Part of what explains these later-in-life infidelity numbers may surprise you — and you may not consider it cheating. In all likelihood, some of this infidelity is explained by circumstances inherent to aging: your partner has dementia. Or cancer. Or is increasingly infirm. Or gives you permission because they can’t meet your intimate needs anymore.

Is that still infidelity? Or something you’d never admit if a writer like me asked you face to face?

This essay was difficult to research. Most people don’t want to discuss such a taboo subject. There is scant religious or psychological guidance for navigating this dilemma.

Many caregivers of incapacitated spouses feel pressure to stay silent and hide the messy realities of aging, which unfortunately only increases their isolation and stress. Think Nancy Reagan caring for the former president from 1994 until 2004. According to a study conducted by Stanford Medicine, 40% of Alzheimer’s caregivers die before the patient — not from disease, but from the toll of caring for their loved one.

This silence about caregivers’ loneliness means it’s especially important to talk about it.

I have one friend, married for 40 years, whose adored, once gentle, still handsome husband is in deep dementia.  Although she does have periodic caregivers, she does not have 24/7 help. Her spouse has begun to push back with all of them, sometimes violently, when it comes to bathing and toilet routines.

Prior to his diagnosis, they had a loving, amorous relationship. While they still live together in their home in Los Angeles, she is “on the brink” of putting him in memory care. “Yeah,” she sighs. “I am only 69. I want another life. We haven’t had sex for four years. I want to have intimacy and a partnership again. And, I don’t want to be judged — I could live another 25 years!”

Dan Gasby, a television executive based in Manhattan and East Hampton, New York, chose to be extraordinarily open about having a girlfriend while caring for an incapacitated spouse. For 28 years, he was married to model and lifestyle guru Barbara Elaine Smith, with whom he ran the eponymous B. Smith magazine, restaurants and lifestyle brand.

Smith was diagnosed with Alzheimer’s in 2013. Soon after, they wrote Before I Forget about navigating Alzheimer’s as a married couple. B. was adamant that Dan, her primary caregiver, be open about the disease and caregiver stresses. He insists he honored his wedding vows, even after his girlfriend, Alex Lerner, came into his life.

Gasby told hosts on The View in 2019 that Smith is “in remarkably good shape from the eyebrows down, but mentally, she’s a toddler.” He went on to explain that “I’m keeping my vows. Vows are to protect, to care for her.” He was both criticized and celebrated following his candor. Barbara Elaine Smith died from Alzheimer’s in 2022.

How long could you care for an incapacitated spouse, without companionship, support and intimacy?

Rabbi Shmulik Friedman, who leads the SOMA Shul of the Chabad of San Francisco, says if you presented this dilemma to him, “I would hug you first.” He’s filled with compassion. However, his rabbinical teaching is clear. “Marriage is more than an emotional, cognitive, intimate connection. It’s a divine, soul-to-soul bond that cognitive decline does not dissolve. As long as your spouse is alive, they deserve exclusivity and dignity.” He adds, “At the same time, caregivers need deep friendships and support, intimacy with God, and affirmation that maintaining the marital commitment is a mitzvah, a selfless, loving act of goodwill.”

Another kind of expert, Dan Savage, the no-nonsense love and sex advisor for the Savage Love syndicated column and Lovecast podcast, offers a different view. Savage advocates that humans are entitled to a “zone of erotic autonomy.”  This means that only we can judge our sex life. Sometimes — perhaps more than we publicly admit — our longtime partners cannot or will not have an intimate relationship. In these cases, he insists, neither our partner, their health or cultural/religious mandates have the right to enforce lifelong celibacy on you.

At times, solo caregiving is the right path. Edie Kressy, a 90-year-old widow and designer from New Hampshire, was married for 57 years to a fellow artist she met at the Rhode Island School of Design in the 1950s. Her husband required full-time care after developing dementia. “Ours became a different kind of romance after Chris got sick,” she explains.

Despite his illness, Edie took him out to coffee every morning, to museums and to restaurants at night. “He was in his own world, but I could still feel him and his love for me, despite his confusion. I refused to spend a night apart. I was happy with him until the end.”

Chris never became combative or hallucinatory, unlike many others in later stages of cognitive decline. However, he was unable to call her by name for years. At the end, under hospice care, one night Chris struggled to speak, finally managing to exclaim, “Edie, I love you.” Those were his last words. He died at 1 a.m.

The point here: a range of reactions to a sexless marriage and the sacrifices of spousal caregiving prevail. This is an intensely personal, private decision. No one can make it for you. No one should judge you for it.

Only you — not friends, your rabbi, your priest or your children — can decide whether you can live fully without companionship and intimacy for the rest of your life. You have the right to relish the years ahead. It’s up to you to choose how to do so, just as it’s up to you to live with that choice.

Sources for help:

Visit the AARP Caregiving website.

Caregiver Action Network can help you find a local support group. Call (855) 227-3640 or visit their website.

Call (866) 232-8484 or visit the Alzheimer’s Foundation of America.

Call (800) 272-3900 or visit the Alzheimer’s Association dementia caregiving page.

Leslie Morgan Steiner is the author of four books, including The Naked Truth, which explores femininity, aging and sexuality after 50, and The New York Times best-selling memoir, Crazy Love. Visit her via her website, Facebook, Instagram and LinkedIn.