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    Dementia Symptoms & Caregiver Strategies: Resolving Family Conflicts When a Loved One is Cognitively Impaired

    Family members need ongoing discussion when making decisions on behalf of the person suffering from cognitive impairment. Some members may disagree about a recommended treatment and get angry or defensive. Or, they may refuse to engage in discussion because they feel the family is "planning for death". Here are some suggestions:

    Involve a third party
    The physician, nurse, social worker, hospital ethics committee member or spiritual leader can be called on to facilitate family meetings and help members work through difficult issues.

    Listen to each family member with respect
    Family members may have different opinions about the person's ongoing treatment and quality of life. Or, they may be at different levels of acceptance about diagnosis. Talking about these perspectives may surface intense emotions, but this is not the time for blaming or attacking others. Each person deserves to be heard and treated with respect.

    Come to agreement
    Talk to the physician about the person's condition, prognosis, and care options, including the burdens and benefits of specific treatments. With the help of a third party, a family can find common ground and agree on decisions that are in the best interest of the person.

    When a loved one is diagnosed as having cognitive difficulties, the effects on the family can be overwhelming. The reality that someone you love has such a devastating disability can trigger a range of emotions — including anger, fear, frustration and sadness. Conflicts are common as family members struggle to deal with the situation. To minimize these conflicts, address the issues together.

    Share responsibility
    Consider each family member's preferences, resources and abilities. Some family members or friends might provide hands-on care, either in their own homes or in your loved one's home. Others might be more comfortable with respite care, household chores or errands. You and your family might also designate someone to handle financial or legal issues.

    Meet regularly
    Plan regular face-to-face family meetings. Include everyone who's part of the caregiving team, including family friends and other close contacts.
    During family meetings, discuss each person's caregiving responsibilities and challenges — and make changes as needed. Be open to compromise and possibilities you hadn't considered on your own.

    If time, distance or other logistical problems are issues for certain family members, consider conference calls or video conferencing. You might also share email updates with the entire family, send updates through Twitter or start a family blog. Caringbridge.org is also a great online resource which can be used as a personalized social network and can facilitate coordinating care and organizing tasks.

    If your family meetings tend to turn into arguments, consider asking a counselor, social worker, mediator or other professional to moderate.

    Be honest
    To help diffuse tension, talk about your feelings in an open, constructive manner.

    If you're feeling stressed or overwhelmed, say so — and then work together to brainstorm more effective ways to share the burden of your loved one's care. Again, work with a professional if needed.

    Be careful to express your feelings without blaming or shaming anyone else. Use "I" statements, such as "I'm having trouble juggling my own schedule with all of Mom's appointments." Keep an open mind as you listen to other family members share their thoughts and feelings.

    Don't criticize
    There are many "right" ways to provide care. Respect each caregiver's abilities, style and values. Be especially supportive of family members responsible for daily, hands-on care.

    Consider counseling
    If you're concerned that the stress of dealing with the illness will tear your family apart, seek help. You might join a support group for caregivers or seek family counseling. A great resource to start with is the Family Caregiver Alliance (caregiver.org).

    Remember, working through conflicts together can help you move on to more important things — caring for your loved one and enjoying your time together as much as possible.

    Cognitive Impairment can have many causes. The patient’s doctor should be consulted to determine a specific diagnosis and treatment options. But whatever the cause, the symptoms are often alike, and the Caregiver Strategies are often similar.

    The information in the resources listed above was compiled by the Ray Dolby Brain Health Center through clinical experience and commonly available published materials. For information on additional Caregiver Strategies, go to: cpmc.org/brainhealth.