Case Review
When the Caregiver Becomes the Crisis: Dementia, Suicidality, and Family Decision-Making
This case presentation explores the complex intersection of dementia care, caregiver mental health, family dynamics, and long-term care planning in an older couple facing simultaneous crises. The husband, an older adult with moderate Alzheimer’s disease, could no longer safely remain independent, while his wife and primary caregiver experienced recurrent psychiatric emergencies involving suicidal ideation and a subsequent intentional medication overdose.
The discussion will examine how an acute behavioral health crisis can destabilize an entire dementia care plan, particularly when the caregiver is also the primary source of supervision, support, and decision-making. It will explore the challenges of coordinating care across psychiatric hospitalization, outpatient behavioral health, primary care, dementia care, emergency services, and legal planning while adult children in a blended family attempt to determine what is safe, sustainable, and appropriate for both spouses. Emphasis will be placed on assessing caregiver capacity, balancing immediate safety needs with long-term planning, navigating family roles and competing perspectives, and recognizing when existing legal and caregiving structures are no longer sufficient. The case will also highlight the advocate’s role in identifying risk, facilitating family communication, coordinating fragmented systems, and helping families move from repeated crisis response toward a more sustainable plan of care.
Learning Objectives:
- Identify how caregiver mental health, caregiver capacity, and dementia-related supervision needs interact to create safety risks for both the person living with dementia and the caregiver.
- Analyze the impact of blended-family dynamics, unclear roles, and inadequate advance planning on decision-making during simultaneous medical, psychiatric, and caregiving crises.
- Demonstrate strategies for coordinating care across behavioral health, primary care, dementia services, emergency systems, and legal planning while balancing immediate crisis stabilization with long-term care needs.
About The Speaker –
Jenny Adamo is a social worker, Board Certified Patient Advocate, Advanced Care Planner, Certified Dementia Planner, and certified End-of-Life Doula with more than 20 years of experience supporting individuals and families through complex healthcare and life transitions.
Her work spans patient advocacy, elder care and planning, dementia and cognitive care navigation, advance care planning, end-of-life support, mental health, trauma, substance use, family systems, and complex medical care coordination. She is known for helping families navigate high-stakes, emotionally charged situations with clarity, compassion, and a strong systems-based approach.
Jenny holds a Master of Social Work from the University of Southern California, with a concentration in Mental Health and a sub-concentration in Geriatrics, and a Bachelor’s degree in Health and Human Development with a concentration in Child Development from California State University, Northridge.
In addition to her advocacy work, Jenny provides education and consultation focused on helping individuals and families better understand their options, clarify decision-making roles, and create sustainable care plans before and during periods of crisis.