When Family Members See Different Paths

Navigating Conflict in Dementia Care

When your loved one has dementia, disagreements within your family aren’t just about who’s right, they cut much deeper. These conflicts touch on love, duty, family history, and deeply held beliefs about care and respect. I want to discuss why these disagreements happen and how you might find your way through them.

When Care Decisions Become Battlegrounds
You might be convinced that mom needs to move to memory care while your brother insists she should stay in her home “where she belongs.” Or perhaps you’re the one providing daily care and feel your siblings don’t understand the reality of the situation because they live across the country.

These disputes aren’t about locations or logistics, they’re about your different ways of showing love and honoring your parent’s dignity. Your sister’s insistence on keeping dad at home might stem from a promise she feels she made to him years ago. Your brother’s push for professional care might come from his fear of not being able to keep mom safe.

Behind each position usually lies love, though expressed in different ways.

The Uneven Weight of Caregiving

One of the most common sources of family friction happens when caregiving falls heavily on one person’s shoulders. If you’re that primary caregiver, you might feel increasingly resentful as your siblings continue their everyday lives while you put yours on hold. Doctor’s appointments, medication management, middle-of-the-night emergencies, they all fall to you.

Meanwhile, if you’re a sibling living at a distance, you might feel guilty but are unsure how to help, or perhaps you feel your offers of assistance are rebuffed or criticized.

This imbalance can reopen old family wounds, such as “You were always mom’s favorite” or “You always think you know better than everyone else.” The stress of caregiving can magnify long-standing family dynamics.

When Money Complicates Everything

Few things can divide families like financial decisions. You might question why your brother wants to hire the more expensive caregiver, wondering if he’s being extravagant with mom’s limited resources. Or perhaps you’re concerned that your sister, who has power of attorney, isn’t transparent about how dad’s money is being spent.

Even more difficult can be disagreements about selling the family home to pay for care. For one sibling, it might be “just a house,” for another, it represents cherished memories they’re not ready to let go.

Finding Your Way Forward

These conflicts are painful but don’t have to fracture your family permanently. Here are some approaches that have helped other families:

Step back and listen. The next time you feel your blood pressure rising during a family discussion, try to hear what’s beneath your sister’s insistence or your brother’s objections. Ask questions like, “What concerns you most about that option?” or “What outcome are you hoping for?”

Bring in an objective voice. Sometimes you need someone without emotional attachment to help guide difficult conversations. A social worker, elder mediator, or family therapist specializing in aging issues can facilitate discussions that family members can’t manage independently.

Document everything. Create a shared care notebook (digital or physical) where everyone can see doctor’s notes, medication changes, and daily observations. This helps ground discussions in facts rather than impressions.

Divide responsibilities according to strengths. Your brother might be terrible at providing hands-on care but excellent at managing finances or researching resources. Your sister might be unable to help daily but could provide weekend relief. Be specific about what you need rather than expecting others to figure it out.

Accept different involvement levels. While ideally everyone would contribute equally, family circumstances vary. Someone raising young children or working multiple jobs may have less time to offer. Focus on what each person can contribute, rather than what they can’t.

Take turns experiencing the daily reality. If you’re the primary caregiver, invite your siblings to truly walk in your shoes—not just for an afternoon visit, but for several days while you take a much-needed break. This firsthand experience often changes perspectives.

When Forgiveness Becomes Essential

There may come a point when you need to let go of your expectation that things should be different—that your sister should visit more often, that your brother should understand, that your family should function the way you believe it should.

This doesn’t mean accepting harmful behavior but recognizing that carrying anger and disappointment adds to your already heavy load. Sometimes the most loving thing you can do—for yourself and your loved one with dementia—is to focus on what’s working rather than what isn’t.

Remember, your shared goal is providing the best care possible for someone you all love. On this difficult journey, it is necessary to be kind to yourself and find compassion for family members struggling in their ways.