Family Matters: Dementia and its Impact on the Individual and their Family

Alzheimer’s is a highly individualized disease and symptoms may vary widely from person to person. Every human being is unique, and we respond to challenges and disease uniquely. Similarly, caregivers and family members of those with dementia represent distinctive family systems and dynamics. The roles we encompass as family members may change with the progression of the disease, particularly as the person requires more care and he/she loses decision-making powers. It is not uncommon for family tensions to grow and conflict may ensue. Moreover, families that were dysfunctional before the onset of the disease, may have an increased level of difficulty in overcoming obstacles and various changes (Podgorski & King, 2009). However, greater family harmony and cohesion has been associated with reduced caregiver burden and reduced levels of behavioral issues and agitation in the care recipient. Understanding the impact of dementia on the entire family unit is of critical importance, if we hope to combat these adverse effects and maintain family solidarity and synchrony.

family conflict

Accept and Ask for Help

Although it can be challenging, if the primary caregiver is receptive to asking for and accepting offers of help, their burden and stress levels may be lessened and greater family harmony may result.  Being specific in asking for help and delegating tasks that match the helper’s strengths are two method of facilitating this process. Click here for a sample check list that caregivers or caregiver-helpers may wish to use.

Ability to be Flexible

Families that are successful in caregiving often possess a greater willingness to adapt to change and be flexible. If the family is too rigid, they may be unable to make changes and everyone potentially suffers. Family members may maintain outdated roles which are no longer beneficial to the group. For instance, a parent that will not accept help from her adult daughter because she believes it is not the daughter’s responsibility, hinders an opportunity to bring needed help into the home. Taking on additional responsibilities and new roles are a difficult transition to undergo, but having clear communication and support within the family unit may help to make the transition less stressful.

Old Family Dynamics Die Hard

Issues related to divorce, family secrets, financial disputes, etc., could be resurfaced as the family convenes over the person’s diagnosis. Families that exhibit dysfunctional patterns of relating to one another before the onset of the dementia, typically continue these patterns throughout the journey with the disease. However, families with higher levels of cohesion, lower levels of family conflict, and clear communication channels, often fare better under the stresses of caregiving.

Although dysfunctional family patterns may be difficult to change, coming together regarding a family member’s dementia may be an opportunity to reconnect and rebuild fragmented relationships within the family. In certain cases, it may be helpful to seek the advice of a professional, such as a family therapist, to help facilitate this change.


Mitrani, V. B., Feaster, D. J., & McCabe, B. E. (2005). Adapting the Structural Family Systems Rating to Assess the Patterns of Interaction in Families of Dementia Caregivers. Gerontologist45(4), 445-455.

Peisah, C. (2006). Family conflict in dementia: prodigal sons and black sheep. International Journal Of Geriatric Psychiatry21(5), 485-492.

Podgorski, C., & King, D. (2009).Losing function, staying connected: family dynamics in provision of care for people with dementia. Generations33(1), 24-29.

Sherman, C. W., & Bauer, J. W. (2008). Financial conflicts facing late-life remarried alzheimer’s disease caregivers*. Family Relations, 57(4), 492-503. Retrieved from

Tremont, G., Jennifer, D. D., & Bishop, D. S. (2006). Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. Dementia and Geriatric Cognitive Disorders, 21(3), 170-4. Retrieved from

Vernooij-Dassen, M., Joling, K., van Hout, H., & Mittelman, M. S. (2010). The process of family-centered counseling for caregivers of persons with dementia: Barriers, facilitators and benefits. International Psychogeriatrics, 22(5), 769-77. doi:

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