The prevalence of aging and dementing parents is increasing and their families are inevitably drawn into their management and care. This situation often creates upheaval for families and particularly for individuals who take on caring roles. There are also major changes in family dynamics; parent and child roles begin to be redefined, shifts in historical, cultural and family roles create stress for and between family members, sometimes with far-reaching consequences for the family and the individual.
Dr Ratna, a psychiatrist who is often called by families to assess or manage a relative with dementia, notes that often the most difficult issue to address is the impact the dementia is having on the families or the carers of the demented patient.
Assessment and management procedures for dementia are reasonably straight forward – and the real need for psychiatric or counselling support often lies more with family members. They can be thrown into depression or anxiety, but their needs frequently go unacknowledged or unrecognised by themselves, as well as by doctors looking after the person with dementia, since the demented person being the patient with the illness, is perceived as the one in need of psychological management.
These situations may be noticeable to an attending psychiatrist but often cannot be directly addressed by the psychiatrist – rather family or carer distress is more likely to present to a GP – and the GP with his/her involvement with family members is in the ideal situation to address them. Dr Ratna will describe a number of typical scenarios, how these might reach GPs, and how GPs might best manage these complex and sensitive situations.