In working with 1,100 people living with dementia, I’ve found working with them is the easy part! It’s their families who are much more challenging.
Typically, the whole family is pulling together to figure out how to manage day-to-day life, the ins and outs of care, and trying to plan ahead. The whole family, except for that one family member.
One thing that usually surprises dementia care partners is the family dynamics that rear their ugly head. You may be the primary care partner for your spouse. You may also be trying to smooth over brewing problems with your spouse’s children from a prior marriage, or even children you had together.
Maybe it’s your sister who lives 3,000 miles away, constantly calling and emailing with unsolicited advice about how you should be caring for your mom.
No matter your particular situation, know that virtually everyone goes through this. You have to deal with criticisms about what you’re doing and how you’re doing it. People remind you what you should be doing, the right way to do things, and on and on. Even childhood “stuff” bubbles up to the surface again.
So what can you do about that one “special” family member? Here are some ideas to try before you feel pushed past the breaking point and irreparable harm is done to your relationship.
Be honest. Is it really them, or could you possibly be contributing to a bad situation, even unwittingly? If you’re not sure, the ideal person to ask is someone who knows you both and can be trusted to gently share the truth with you. This person should also not further stir the pot.
If you’re contributing, it could be a sign of burnout. Move self-care to the top of your list immediately. I know care partners hate to talk about self-care, let alone “indulge” in it. But here’s the thing. If you don’t take care of yourself, something bad is going to happen to you. Then who is going to take care of your parent or partner?
If you’re clear it’s really your family member that is creating the family conflict, then it’s time to resolve the situation. As someone who looks for a table to dive under at the first sign of conflict myself, I understand if that makes you squirm. But in this case, we are talking about a disease process that usually last 7-12 years. It can even take up to 20. That’s an excruciatingly long time to live with family conflict.
We’ve been socialized to think that “boundary” is a bad word. It is often considered a sign of selfishness. Not so! Boundaries are simply a container, much like your coffee cup. That container allows you to drink your coffee rather than wear it.
Setting boundaries with others allows them to understand how they’re permitted to treat you. It provides guidelines for you to be clear on what’s okay and what’s outside the lines.
Because I’m non-confrontational by nature, I like to pretend I’m Maya Angelou in high-stress situations. I pick her because she projected such self-awareness and dignity. Can you imagine anyone having the nerve to violate her boundaries? I sure can’t!
Knowing your boundaries also allows you to know – before you’re in the thick of an emotional conversation – what you’re willing to do to resolve the situation, what you’re willing to work on as a team, and what’s non-negotiable.
We’re all far more open to correction when we’re open, not when we’re feeling attacked. It’s easy to feel attacked when we feel misunderstood, like no one understands where we’re coming from. In my article “Which Is Your Tribe?” I identify various types of family members who often come across a certain way, but there’s something more going on below the surface.
And of course we need to feel safe in order to feel open. Fear has a way of obscuring this very basic truth.
Fear usually shows up as anger. There’s fear of the unknown, unmet needs, the future, helplessness and fear of feeling all the feelings. There’s plenty of fear to go around, and yet it’s not okay to act it out.
You and your family member both need to feel safe in order to attempt resolution. If your family member starts yelling, try saying, “I agree this is important. I can’t think clearly when there’s yelling.” Note there’s not a “but” connecting the sentences, which gives the listener permission to disregard the first part of whatever you’ve said.
And rather than saying “when you’re yelling,” it’s the more neutral construction of “when there’s yelling.” These are both to help de-escalate a situation.
You can also try, “I can’t concentrate, not like this.” Whatever it is you say, your family member needs to immediately change to a constructive course of action. If she’s not able to do that, (think of Maya Angelou and) end the conversation!
Listen to both your family member and yourself. Be aware of the language you use in your own head in thinking about this situation. Are you using words like “tantrum,” “meltdown,” “deal with,” or “handling.”
Would you rather “deal with” someone, or have a conversation? Would you rather spend your morning “handling” a situation, or resolving it? Making just small changes in how you think of it can make it easier for you, before the interaction even begins.
Assuming you’re able to have a calm interaction, listen fully to what your family member has to say. Don’t justify your actions, thoughts, or feelings. Just listen. This is much easier said than done, but so worth the effort!
Ask clarifying questions, then paraphrase back what you heard. Ask, “Is that right?” The last thing you want when you’re attempting to repair damage is more misunderstandings.
Just like you would with your parent or partner who’s living with dementia, focus on the feelings behind the words and acknowledge them. We can all be imprecise in our words, but the emotional power behind them is hard to miss.
Validate what you heard. Validation is not the same as agreement; the message is, “I heard you, and I value you.” This one step often is when the conversation turns the corner out of bad feelings and into a constructive path forward.
The temptation, especially for the go-getters among us, is to move straight to this part and skip past listening and validating. Doing that is like trying to tell your husband about a problem because you need to talk about it. Then having him cut you off to offer solutions, because he needs to fix it. That is annoying!
Only after listening and making sure you heard what you think you heard will you have any chance of moving on to a solution. This can be frustrating, especially if the solution is perfectly obvious to you while equally as invisible to your family member.
Start by asking, “What does a solution look like to you?” You may – unsurprisingly – find that you two have vastly different ideas of what a solution looks like. If so, it’s better to know that now and work toward a mutually agreeable solution than end up in another confrontation.
Once you’re on the same page, it’s time to agree and devise a plan. Pull out a calendar and get serious about who’s going to do what and when (and maybe even how, if appropriate). Again, “What does that look like to you?” is a magically clarifying question that eliminates misunderstandings straight out of the gate.
Sometimes it’s easy to lose sight of the fact that everyone involved has a strong opinion because they all love the person who’s living with dementia. Use that to your advantage and to your loved one’s advantage. Keep coming back to that.
If you find that you’ve tried everything and there’s just not a way to successfully work with that one family member on your own, consider using a professional who can help manage expectations and emotions while also working toward a solution.
And please don’t waste time beating yourself up! This disease process is difficult enough. You don’t need added layers of difficulty, right?
Instead, ask yourself, “What’s the kindest, move loving thing I can do for myself in this moment?” And then do it!
Have you had experience in dealing with a family conflict with dementia? What did you do to resolve it? Please share what worked or didn’t for you.