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6 Tips To Overcome Challenging Family Dynamics in caring for a parent

Dementia Care: 6 Tips to Overcome Challenging Family Dynamics

Strategies to address and communicate the differences in how to manage dementia care needs within your family?

Published by

Valerie Feurich

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Family/Friends

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By Valerie Feurich, PAC Team Member

Do you have a parent or other family member that you know or suspect is living with dementia?

Are you dealing with people who see the situation differently from you? Or, are there differences in how to manage dementia care needs within your family?

Situations like these are common when a family member is living with dementia, and can be tricky to manage. Conflicting views can easily leave you feeling frustrated, particularly if you’re the one caring for the person you’re concerned about. Yet, having a dementia care team by your side that sees things eye-to-eye can have a significant positive impact on the person living with dementia, you, and your other family members.

So, what can you do to get everyone on the same page? While there’s no one-size-fits-all solution as situations are as varied as they come, here are six tips for you to try.

  1. Recognize that you may have differing experiences
Paradigm Shift spelled out on a chalkboard

Let’s say you’re one of three siblings, and you’re the one actively caring for your mom who you suspect is experiencing Alzheimer disease. Your siblings visit once every six to twelve months, but talk with your mom on the phone at least weekly. You notice that while you get two-to-three-word answers to your questions from your mom, when your sister calls, your mom happily chats away for prolonged periods of time. Why is that?

One of the reasons is that for many people the area of the brain that houses the skill of idle chit-chat remains untouched by the dementia for a while. So, if your sister gives a cue that calls for a social chit-chat response from your mom, she’s likely to experience a more typical conversation.

On the other hand, if you ask your mom an open-ended question like, What would you like for dinner?, you’re asking a brain that is no longer functioning as it once did to sort through thousands of options, narrow them down, and pick one. Essentially, while your sister is engaging an ability your mom still has (chit-chat), your requests may require processing abilities your mom no longer has. So, while you may think your sister is in denial about your mom’s brain changes, it’s likely that she’s simply having a different experience.

What can you do? Try letting go of the idea that your family member is in denial, but instead focus on what it is you’d like help with from your sibling. By recognizing that your experiences differ and shifting your focus on what they can do to help instead, no matter whether they recognize the dementia or not, you’re actively shifting your energy to a place that can make a difference.

  1. Approach with curiosity, not accusations
Letters cut out to spell curiosity with a magnifying glass laying next to it

The key to overcoming family dynamics in dementia care is to find a common ground to build upon. But, getting on the same page is difficult when your experiences differ. So, what can you do?

Try approaching your conversations with curiosity. Instead of making statements or accusations of how you see things, try to figure out where they are coming from. As an example, instead of saying, You’re in denial if you don’t see how mom has changed, say I’m curious – Have you noticed any changes in mom lately? If your sibling says yes, you can ask follow-up questions to dig a little deeper. If they answer no, see if you can become a little more specific with a You share-I share type statement. How does that work?

Simple – start by sharing an observation you have made, and then ask if they’ve noticed anything similar. This could go something like I noticed mom is having more difficulty with making decisions. Have you noticed anything like that? By sharing your experience first, and then asking them a specific follow up question, you encourage them to dig a little deeper. By approaching the conversation with curiosity, you create a platform of open discussion that gives you the opportunity to find a common ground.

  1. Don’t be a boss, be a care partner
The word Partner pointing out to share, participate, help, support, assist

Do you like being told what to do? How does it feel to be bossed around? Chances are, you don’t enjoy it much. Yet, in our daily haste to get things done, it is common to fall into bossy patterns of telling someone else what to do. This can create lasting resentment and conflict. Whether you’re talking to the person living with dementia or another family member, see if you can use a team approach instead.

As an example, instead of saying, Mom, it’s time to eat your breakfast, try saying Oh, mom, look at this yummy breakfast spread. That sure smells good. Should we try a bite? What do you think?

Will that take more time? Yes, possibly, but think about the time you’re saving during future interactions that are void of built-up resentment. Even if the person living with dementia doesn’t remember what you said, they’re likely to remember how you made them feel.

  1. Use Teepa Snow’s dementia communication strategies
notepad with Communication Strategy written on cover

Have you noticed a pattern in the above points? They all include one or more forms of Teepa Snow’s Positive Approach to Care communication techniques.

To help you better remember them so you can try them during your next conversation, I’ve listed a few of them for you:

  • I’m wondering about and what do you think?

By starting a statement with I’m wondering about, you shift from making an affirmative, bossy statement to a softer, less confrontational observation. By following your statement with what do you think?, you’re inviting the other person to share their point of view. By doing this, you’re showing the other person that you care and respect their thoughts, making it more likely for the two of you to find a common ground.

Example: I’m wondering whether mom’s condition has really progressed these last few months. It seems like she’s more confused lately. What do you think?

  • It sounds like or It seems like

By starting a sentence with it seems like, or responding to someone else’s statement with it sounds like, you engage in productive conversation that is less confrontational. By incorporating these phrases into your communication, you can share your observations while leaving room for the other person to respond.

Example: It seems like mom is more confused lately. It sounds like you’ve noticed that too.

  • I share, you share

Just as mentioned in #2, using the I share, you share technique can help get you and the other person on the same page. By sharing your thoughts first you’re breaking possible barriers. Then by proactively inviting the other person to do the same, you’re signaling that you care and respect their thoughts. While this technique comes in handy during many daily interactions, it can also be very helpful when you’re talking to a person living with dementia. In this case, this technique can trigger an automatic response that can help you garner information. Teepa Snow’s Positive Physical Approach (PPA) makes use of this phenomenon with the simple interaction of Hey, I’m Valerie. And you are? In most cases, the other person will automatically respond by telling you their name.

Example: Dinner is my favorite meal of the day. What’s yours?

  • Can I ask you for a favor?

The desire to feel needed, having a purpose, and wanting to contribute is at the core of most people’s being. By asking the other person for their help, you’re demonstrating that you value their contributions. You may be thinking – but I can do things much faster by myself. Yes, you possibly can. But with that, you forgo the opportunity to create a positive interaction. You forgo the opportunity to help the other person feel valued and needed. It seems like that would be worth slowing down a bit. What do you think?

Example: Mom, can I ask you for a favor? You have such a good eye for making the dinner table look beautiful; much better than I ever could. Do you think you could help me set that up? I would appreciate that so much.

  • Can we try?

Is a person in your family not a fan of change? Yet, you’re finding yourself in a situation where change is needed? One way to reduce resistance to a change is by asking the person, Can we try? By asking this question, you make the change feel less permanent and daunting. By asking the question, you’re also letting the person know that their thoughts matter, instead of telling them what to do.

Example: Yeah, you feel just fine driving the car. I’m wondering, what would you think of having Julia drive this month instead? She hasn’t had her license for too long, and you could probably teach her a thing or two. What do you think? Can we try having Julia drive you for a month, or something else?

  • This or that? or This or something else?

When a person is living with dementia, asking open-ended question like What would you like for dinner? Or What do you want to drink? can overwhelm their brain and render your communication efforts ineffective. Why? Think about it – how many things does your brain have to process to answer the question of what they’d like for dinner? How many possible options are there to mentally sort through? Instead, by offering pre-set choices, you’re actively supporting them in making a decision. Try offering this or that or this or something else options, and narrow down choices by adapting the next questions to their previous answer.

Example: Mom, would you like chicken or pasta for dinner? Chicken? Great. Would you like your chicken with rice or mashed potatoes?
Mom, would you like coffee, or something else? Something else? Tea, or something else?

  • Mirror or Repeat

Whether the person you’re talking to is living with dementia or not, rephrasing the last few words they said and repeating them back before adding your thoughts can help keep a conversation going. Why? For a person living with dementia, having you rephrase and repeat what they’ve said can help them process the conversation. And even if the person isn’t living with brain change, hearing you repeat what they’ve just told you helps make the other person feel listened to and understood.

Example: Mom: I’m hungry; I haven’t eaten all day.
You: You haven’t eaten all day. Yeah, no wonder you’re hungry. Would you like a sandwich, or something else?

  1. Go with the flow and adapt as needed 
Adapt to Changes written on a piece of paper

You may be familiar with the tongue-in-check definition of insanity: Doing the same thing over and over and expecting different results. Just as with many other things in life, this approach isn’t going to help you much in dementia care.

Instead, if things are not going as you planned, whether it’s your interaction with the person living with dementia or another family member, what can you do differently?

Instead of trying to push through your agenda when things go sideways, you’re almost always better off stepping away and taking a deep breath. Try again another time. Forcing your will or needs onto someone else will likely only escalate the situation.

While it isn’t always easy, putting your ego aside and letting go of being right will serve you well in the long run. Even if you don’t feel like you did something wrong, sometimes it’s still best to apologize and let it go to safeguard your relationship.

“Apologizing does not always mean you’re wrong and the other person is right. It just means you value your relationship more than your ego.” – Mark Matthews

  1. Get support, and do so early
puzzle piece that says, Support

If you have read a few of our blogs, you may have noticed a pattern: We repeatedly recommend for you to build your care team, and to do it early. Why? Caring for a person living with dementia can be truly exhausting and the truth is, you can’t pour from an empty cup. Having a team of people that enable you to take time off when needed can have a significant positive impact on everyone’s dementia journey.

If dynamics make it difficult to find a family-based care team, consider other support resources. Whether it’s a local support group, faith-based organization, or local Area Agency on Aging, finding support from others going through similar experiences can offer powerful rewards.

In addition, Teepa Snow’s Positive Approach to Care (PAC) offers a free 30-minute consultationwith a Certified PAC Consultant. You may also consider joining a PAC Care Partner Support Series– a five week series of live, virtual group meetings that provide you with knowledge, tools, and the companionship of others who are on a similar journey as you.

Conclusion:

Challenging family dynamics, whether it’s the relationships with your sibling(s) or parent, can become amplified when dementia-related stress or worries take hold. While there’s no silver bullet to overcome these challenges, recognizing that other family members may have a different experience can help. Approaching situations with curiosity and as a partner, not a boss, can help you find a common ground to build upon. Using Teepa Snow’s communication strategies, adapting as needed, and getting support will help everyone involved experience a better dementia care journey.

1 thought on “Dementia Care: 6 Tips to Overcome Challenging Family Dynamics”

  1. AvatarSYDNEY KENNEDYAs a Placement and Referral Specialist, I try to work with families all the time. The biggest challenges come with one family member whose anxiety rules and the rest of the family enables her for fear of retribution or confrontation, which has been their experience. This article is golden for me to send to my client families. Thank you.

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