Family conflict in caring for someone with dementia

Abstract

Background:
Families are fundamental in dementia caregiving, yet the experiences of the wider family in this context is underrepresented in the literature. Dementia caregiving has been reported to be more stressful when compared with other chronic diseases, leaving families vulnerable to caregiving conflict. Research exploring conflict and solutions within the wider family was deemed necessary to facilitate a better caregiving journey for all involved.

Aims:
This research aimed to examine family conflict in dementia caregiving to improve understanding, inform the direction of future research, and support individuals with dementia and their families to improve their relational and care outcomes.

Methods:
This thesis commences with a comprehensive review of literature (Chapter 1) discussing dementia symptoms, prevalence and management strategies, the advantages and challenges of dementia care that is provided by family, the risk of conflict for dementia caregiving families, and the need for further research into this topic. The methodology and conceptual framework that guided the research are then reported (Chapter 2), including family systems theory, family systems illness model, family conflict and family resilience, and qualitative research methods and design. To achieve the aims of this research, a systematic review (Chapter 3) was conducted, which examined the effectiveness of family-focused interventions for addressing family conflict. Next, a scoping review (Chapter 4) was performed, which explored factors associated with family conflict, who was involved, the impact of conflict and resolution strategies. The experiences of family conflict and dementia support were then explored (Chapter 5) from the perspective of community care staff and volunteers. Lastly, the lived experience of conflict was examined from the perspective of caregiving families (Chapter 6). This thesis concludes with a consideration of the collective research findings, implications for individuals living with dementia and caregiving families, and recommendations for policy, practice and future research (Chapter 7).

Results:
The systematic review identified a lack of reliable interventions that addressed conflict and included members of the wider family. The scoping review found that family and external individuals experienced conflict relating to caregiving disagreements and family roles. Care provision was affected, and conflict was addressed through effective communication and caregiving collaboration. Care staff and volunteers reported the need for improved dementia awareness and holistic support provision to reduce the risk of conflict and improve care outcomes. Families reported distinct responses to conflict, which were influenced by their relationships and beliefs.

Conclusions:
Conflict affected caregiving families and enhanced family support was necessary to reduce this risk. Future interventions, research and policy should include multiple family members and seek to improve support provision, solidarity and communication between members to improve adaptation and care outcomes.

Date of Award	Jun 2025
Original language	English
Sponsors	Department for the Economy
Supervisor	Kelly Norwood (Supervisor), Claire McDowell (Supervisor) & Gerard Leavey (Supervisor)