Dementia caregiving can expose hidden family tensions – but early planning can ease the strain

A sociologist studying family caregiving describes how dementia, which now affects over 5 million U.S. adults 65 and older and is projected to top 13 million by 2060, tends to expose rather than create family tension. Using RAND survey data, the researcher finds Americans expect families to shoulder more responsibility for a relative with dementia than one with a physical illness, even as families shrink and more adults age without nearby children.

Focus group participants described feeling thrown into caregiving because no advance plans existed, leaving them to guess at a relative's wishes as the disease progressed. The piece recommends early legal planning, such as healthcare directives, and ongoing collaboration that keeps the person with dementia part of the conversation for as long as possible.

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