The protective cover of denial is removed from the family with the growing realization of the symptoms of Alzheimer’s disease. Family members are no longer shielded from the difficult decisions that need to be made about the care of the impaired loved one, and, at this point, the family is left open and vulnerable to conflict about exactly what needs to be done. This can be one of the most difficult challenges in caring for the patient with Alzheimer’s disease, because the conflict seems to emerge quite unexpectedly. In my conversations with family caregivers, I have found that family conflict over care plans and caregiving can create a severe source of stress, far beyond the actual tasks of caregiving.
Prolonged caregiving to a relative with Alzheimer’s disease is a situation in which latent family strains are often activated, and conflict can displace prior family harmony. When this occurs, family members are likely to bear the emotional consequences. Family conflict can leave family members with severe emotional scars that may never heal. Having attended many support meetings where I heard stories of severe family conflict over caregiving dilemmas, I can recall feeling fortunate in some ways that my husband was Katharine’s only son, and that we were the only available caregivers. My husband’s father and brother had died several years before the onset of Katharine’s illness, and although we often wished for someone to share the burden of the caregiving