{"id":780770,"date":"2026-09-24T06:22:17","date_gmt":"2026-09-24T06:22:17","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/780770\/"},"modified":"2026-09-24T06:22:17","modified_gmt":"2026-09-24T06:22:17","slug":"dementia-caregiving-can-expose-hidden-family-tensions-but-early-planning-can-ease-the-strain","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/780770\/","title":{"rendered":"Dementia caregiving can expose hidden family tensions \u2013 but early planning can ease the strain"},"content":{"rendered":"<p>\u201cFamilies are messy, aren\u2019t they?\u201d a daughter commented during a series of focus groups I ran with <a href=\"https:\/\/doi.org\/10.1177\/15333175251357328\" rel=\"nofollow noopener\" target=\"_blank\">caregivers of older adults with memory issues<\/a>. <\/p>\n<p>Many people would agree with that sentiment. The <a href=\"https:\/\/doi.org\/10.1016\/j.jagp.2017.12.004\" rel=\"nofollow noopener\" target=\"_blank\">complexity can be compounded<\/a> when caring for someone who has a disease such as Alzheimer\u2019s or another form of dementia that impairs their <a href=\"https:\/\/doi.org\/10.1177\/14713012251324705\" rel=\"nofollow noopener\" target=\"_blank\">memory, language and sometimes personality<\/a>. <\/p>\n<p>Yet discussing how caring for their loved one affects family dynamics \u2013 be it longstanding family feuds, unmet expectations about family responsibilities or the desire to keep health issues private \u2013 is often seen as taboo. <\/p>\n<p>I am a sociologist and demographer <a href=\"https:\/\/scholar.google.com\/citations?user=tFkt-zEAAAAJ&amp;hl=en\" rel=\"nofollow noopener\" target=\"_blank\">studying how family dynamics<\/a> change as people get older and need care \u2013 and how that relates to expectations about caregiving for older adults.<\/p>\n<p>The makeup of families is changing, and that\u2019s shaking up how caregiving can reverberate through family relationships. Caring for <a href=\"https:\/\/theconversation.com\/family-and-friends-shoulder-the-real-cost-of-dementia-224b-in-unpaid-care-256782\" rel=\"nofollow noopener\" target=\"_blank\">family members or friends with dementia<\/a> can be especially thorny because of the ways the condition changes how a person behaves and how they <a href=\"https:\/\/doi.org\/10.1016\/j.jagp.2017.12.004\" rel=\"nofollow noopener\" target=\"_blank\">interact with others<\/a>. But a little planning and support can help families through the challenges. <\/p>\n<p>Caregiving is a common experience<\/p>\n<p>Americans are living much longer, which means that people are sharing <a href=\"https:\/\/doi.org\/10.1007\/s13524-019-00766-6\" rel=\"nofollow noopener\" target=\"_blank\">more years of their lives<\/a> with their family members. For instance, children are more likely to have <a href=\"https:\/\/doi.org\/10.1007\/s13524-019-00795-1\" rel=\"nofollow noopener\" target=\"_blank\">a living grandparent<\/a> today than in previous generations. <\/p>\n<p>And that means it\u2019s more likely that people will have a parent or grandparent who may experience cognitive decline at some point in their lives.<\/p>\n<p>More than 5 million U.S. adults age 65 and older are currently <a href=\"https:\/\/doi.org\/10.1002\/alz70860_101358\" rel=\"nofollow noopener\" target=\"_blank\">living with dementia<\/a> \u2013 an umbrella term describing a <a href=\"https:\/\/www.nia.nih.gov\/health\/alzheimers-and-dementia\/what-dementia-symptoms-types-and-diagnosis\" rel=\"nofollow noopener\" target=\"_blank\">loss of cognitive abilities<\/a> around thinking, remembering and reasoning. That number is expected to reach over <a href=\"https:\/\/doi.org\/10.1016\/j.jalz.2018.06.3063\" rel=\"nofollow noopener\" target=\"_blank\">13 million by 2060<\/a> as the baby boomers age. <\/p>\n<p>            <a role=\"button\" aria-label=\"Zoomable image\" aria-haspopup=\"dialog\" href=\"https:\/\/images.theconversation.com\/files\/760896\/original\/file-20260918-71-oj8l2g.jpeg?ixlib=rb-4.1.1&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\"><img decoding=\"async\" alt=\"Multigenerational family laughing together on sofa at home.\" src=\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/09\/file-20260918-71-oj8l2g.jpeg\" class=\"native-lazy\" loading=\"lazy\"  \/><\/a><\/p>\n<p>              Caregiving for people with dementia is a family affair.<br \/>\n              <a class=\"source\" href=\"https:\/\/www.gettyimages.com\/detail\/photo\/multigenerational-family-laughing-together-on-sofa-royalty-free-image\/2264358194\" rel=\"nofollow noopener\" target=\"_blank\">Flashpop\/DigitalVision via Getty Images<\/a><\/p>\n<p>People with dementia interact with many people in their families and communities. Over half of Americans say that they <a href=\"https:\/\/ropercenter.cornell.edu\/ipoll\/search?q=USAP.071311.R20\" rel=\"nofollow noopener\" target=\"_blank\">know someone with dementia<\/a>, and more than a third of extended families <a href=\"https:\/\/doi.org\/10.1002\/alz.70451\" rel=\"nofollow noopener\" target=\"_blank\">include an older adult with dementia<\/a>. In 2022, over 5 million family caregivers were <a href=\"https:\/\/doi.org\/10.1377\/hlthaff.2024.00978\" rel=\"nofollow noopener\" target=\"_blank\">taking care of an older adult with dementia<\/a>. That\u2019s 1 out of every 5 people caring for an older adult in the U.S. <\/p>\n<p>At the same time, family sizes are shrinking, and more <a href=\"https:\/\/doi.org\/10.1093\/geronb\/gbx068\" rel=\"nofollow noopener\" target=\"_blank\">older adults do not have children<\/a> or their children live far away \u2013 and more distance often <a href=\"https:\/\/doi.org\/10.1016\/j.socscimed.2021.114627\" rel=\"nofollow noopener\" target=\"_blank\">equates to less caregiving<\/a>. Meanwhile, cultural acceptance of the idea of <a href=\"https:\/\/theconversation.com\/the-real-reason-many-americans-are-cutting-ties-with-their-parents-and-siblings-283957\" rel=\"nofollow noopener\" target=\"_blank\">family estrangement<\/a> or going \u201cno contact\u201d has increased \u2013 as has a growing recognition of <a href=\"https:\/\/doi.org\/10.1111\/jomf.70065\" rel=\"nofollow noopener\" target=\"_blank\">chosen family<\/a>. That means more older adults are <a href=\"https:\/\/doi.org\/10.1177\/0164027520907332\" rel=\"nofollow noopener\" target=\"_blank\">aging alone<\/a>, with limited support, or with other people who may not have the legal benefits of immediate family. <\/p>\n<p>The caregiving landscape is shifting, too. <\/p>\n<p>Historically, middle-age women were the <a href=\"https:\/\/doi.org\/10.1093\/geront\/gnx093\" rel=\"nofollow noopener\" target=\"_blank\">largest group of caregivers<\/a> \u2013 generally, the daughters of aging parents. Adult children continue to be the <a href=\"https:\/\/doi.org\/10.1377\/hlthaff.2024.00978\" rel=\"nofollow noopener\" target=\"_blank\">largest group of caregivers<\/a> for older adults with dementia in the U.S., but their characteristics are changing. <\/p>\n<p>Today, more caregivers are <a href=\"https:\/\/doi.org\/10.1377\/hlthaff.2024.00978\" rel=\"nofollow noopener\" target=\"_blank\">age 65 and older themselves<\/a>. And <a href=\"https:\/\/doi.org\/10.1111\/jomf.70030\" rel=\"nofollow noopener\" target=\"_blank\">more men<\/a>, <a href=\"https:\/\/doi.org\/10.1215\/00703370-11383976\" rel=\"nofollow noopener\" target=\"_blank\">young people<\/a> and <a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.21697\" rel=\"nofollow noopener\" target=\"_blank\">friends are also providing care<\/a>. <\/p>\n<p>All these factors combined are changing who is available to provide care for aging family members. <\/p>\n<p>Great expectations<\/p>\n<p>Dementia can amplify both expectations and family messiness. <\/p>\n<p>Using data from a survey conducted by the RAND Corporation, a nonprofit research organization, my colleagues and I found that Americans feel <a href=\"https:\/\/doi.org\/10.1002\/bsa3.70066\" rel=\"nofollow noopener\" target=\"_blank\">families have a greater responsibility<\/a> to care for an older relative with dementia than for a relative with a physical illness.<\/p>\n<p>These expectations can <a href=\"https:\/\/doi.org\/10.1177\/10748407241288606\" rel=\"nofollow noopener\" target=\"_blank\">motivate some caregivers<\/a> to provide care, even in difficult circumstances. But for others, old family disagreements, rivalries or unresolved points of tension can continue to haunt relationships in ways that can clash with <a href=\"https:\/\/nyupress.org\/9781479813339\/families-we-keep\/\" rel=\"nofollow noopener\" target=\"_blank\">family expectations<\/a> around caretaking. <\/p>\n<p>Dementia further complicates these feelings. For instance, one participant in our focus groups described a friend who struggled with caregiving because he felt compelled to do it even though his dad had not cared for him when he was a child. <\/p>\n<p>Shrinking families also leads to constrained options. Some caregivers report feeling <a href=\"https:\/\/doi.org\/10.1007\/s12529-023-10246-2\" rel=\"nofollow noopener\" target=\"_blank\">they have no choice<\/a> but to provide care, especially when the older adult has dementia. In our focus groups, this was often because no one else was available due to small family sizes or even family estrangement. <\/p>\n<p>Caring for someone with dementia often requires a <a href=\"https:\/\/doi.org\/10.1093\/geronb\/gbz065\" rel=\"nofollow noopener\" target=\"_blank\">large circle of support<\/a>, leading to potential <a href=\"https:\/\/doi.org\/10.1093\/geront\/gnag040\" rel=\"nofollow noopener\" target=\"_blank\">clashes between family members<\/a>. In our focus groups, this played out as caregivers disagreeing on roles and responsibilities in ways that often reflected prior family tensions. <\/p>\n<p>            Changing family structures are shaking up who\u2019s available to provide care for older adults.<\/p>\n<p>What can you do?<\/p>\n<p>There\u2019s likely no way to untangle decades of family dynamics before caretaking responsibilities kick in. But a few guidelines can help ensure that caregivers feel supported.<\/p>\n<p>Thinking ahead: Many caregivers in our focus groups felt thrown into their roles because their older friend or relative <a href=\"https:\/\/doi.org\/10.1177\/15333175251357328\" rel=\"nofollow noopener\" target=\"_blank\">did not make plans for their care<\/a> in case their health were to fail. The lack of planning meant that caregivers were left to make decisions for the older adult, while worrying about whether they were <a href=\"https:\/\/doi.org\/10.1080\/13607863.2015.1049117\" rel=\"nofollow noopener\" target=\"_blank\">adhering to their preferences<\/a>. Many caregivers <a href=\"https:\/\/doi.org\/10.1332\/23978821Y2025D000000166\" rel=\"nofollow noopener\" target=\"_blank\">found this incredibly stressful<\/a> \u2013 particularly as dementia\u2019s progression makes it more difficult for people to make their wishes clear. <\/p>\n<p>That\u2019s why making plans in advance is vital \u2013 both for <a href=\"https:\/\/dementia-directive.org\/\" rel=\"nofollow noopener\" target=\"_blank\">dementia specifically<\/a> and for <a href=\"https:\/\/doi.org\/10.1093\/geroni\/igx012\" rel=\"nofollow noopener\" target=\"_blank\">other types of health issues<\/a>. Preparation can include making <a href=\"https:\/\/theconversation.com\/end-of-life-planning-can-be-hampered-by-misconceptions-but-the-process-is-easier-than-you-might-think-249265\" rel=\"nofollow noopener\" target=\"_blank\">legal arrangements<\/a>, such as healthcare directives and wills, as well as deciding who should provide care and what that care should entail. This is especially important for people who may <a href=\"https:\/\/doi.org\/10.1016\/j.socscimed.2026.119251\" rel=\"nofollow noopener\" target=\"_blank\">not have family available<\/a> to care for them.<\/p>\n<p>Collaboration: Caring for a family member \u2013 particularly someone undergoing challenging cognitive changes and especially with tricky family history \u2013 may take a lot of <a href=\"https:\/\/doi.org\/10.1177\/1471301218780768\" rel=\"nofollow noopener\" target=\"_blank\">negotiation<\/a>, <a href=\"https:\/\/doi.org\/10.1111\/jpm.12822\" rel=\"nofollow noopener\" target=\"_blank\">communication<\/a> and <a href=\"https:\/\/doi.org\/10.1111\/jftr.70054\" rel=\"nofollow noopener\" target=\"_blank\">flexibility<\/a>. It is important to continue to <a href=\"https:\/\/doi.org\/10.1177\/14713012251389447\" rel=\"nofollow noopener\" target=\"_blank\">include the older adult in these conversations<\/a> even as their <a href=\"https:\/\/www.girlfridayproductions.com\/titles\/before-i-lose-my-own-mind\" rel=\"nofollow noopener\" target=\"_blank\">disease progresses<\/a>. <\/p>\n<p>In our focus groups, caregivers said they most appreciated <a href=\"https:\/\/doi.org\/10.1145\/3555133\" rel=\"nofollow noopener\" target=\"_blank\">knowing they weren\u2019t alone<\/a> in dealing both with caregiving and family dynamics. <a href=\"https:\/\/doi.org\/10.1093\/gerona\/glae036\" rel=\"nofollow noopener\" target=\"_blank\">Respite care<\/a> and other programs, including <a href=\"https:\/\/doi.org\/10.1080\/13607863.2023.2194848\" rel=\"nofollow noopener\" target=\"_blank\">support groups<\/a>, can give caregivers some time away. Families are <a href=\"https:\/\/doi.org\/10.1186\/s13690-018-0316-y\" rel=\"nofollow noopener\" target=\"_blank\">often unaware<\/a> of <a href=\"https:\/\/doi.org\/10.1002\/alz.70013\" rel=\"nofollow noopener\" target=\"_blank\">these programs<\/a>. These programs may also not be everyone\u2019s cup of tea \u2013 perhaps due to <a href=\"https:\/\/doi.org\/10.1332\/23978821Y2024D000000059\" rel=\"nofollow noopener\" target=\"_blank\">cultural or personal values<\/a> around avoiding outside involvement.<\/p>\n<p>If you are seeking outside support, start with your local <a href=\"https:\/\/ihpi.umich.edu\/news-events\/news\/7-things-every-family-caregiver-should-know-many-dont\" rel=\"nofollow noopener\" target=\"_blank\">Area Agency on Aging<\/a>. These agencies are a network of <a href=\"https:\/\/eldercare.acl.gov\/home\" rel=\"nofollow noopener\" target=\"_blank\">local nonprofit organizations<\/a> around the country that help connect older adults and their caregivers to resources, including help with meals, long-term care planning or accessing respite care.  <\/p>\n<p>Seeking community: Caregiving often involves <a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.44315\" rel=\"nofollow noopener\" target=\"_blank\">supporting other caregivers<\/a>. For example, one participant in our focus groups noted that her efforts caring for her grandmother also supported her mother, whom she saw as the main caregiver. But because family dynamics and histories vary so widely, some care networks function cohesively <a href=\"https:\/\/doi.org\/10.1093\/geronb\/gbaf040\" rel=\"nofollow noopener\" target=\"_blank\">while others may struggle<\/a>. Support groups can help families connect with others <a href=\"https:\/\/www.mentalhealth.com\/library\/support-groups\" rel=\"nofollow noopener\" target=\"_blank\">navigating similar challenges<\/a>.<\/p>\n<p>In addition, community engagement for people with dementia and their caregivers is increasingly widespread. Local <a href=\"https:\/\/www.dementiafriendlyservices.org\/\" rel=\"nofollow noopener\" target=\"_blank\">\u201cdementia friendly\u201d programming<\/a> can provide outings and other activities, as well as another place to meet other caregivers similar to support groups.<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cFamilies are messy, aren\u2019t they?\u201d a daughter commented during a series of focus groups I ran with caregivers&hellip;\n","protected":false},"author":2,"featured_media":780771,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":["post-780770","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-health","tag-healthcare","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/780770","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=780770"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/780770\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/780771"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=780770"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=780770"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=780770"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}