Abstract
When psychiatric or cognitive decline disrupts the elder's ability to make independent decisions, grown children may be called upon to make decisions for their parents for the first time. Successful case management and treatment will depend upon, the clinician's recognition of the distinctive issues posed by this unique stage of family development. The normative stresses and conflicts of this transition period are discussed, along wlth several dimensions of family functioning observed to influence its course. A case example is used to illustrate the clinician's role in facilitating change, as well as the patterns of denial and resistance often encountered.
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